Organization Active NPI

Golden Oak Dermatology, P.C.

  • Dermatology Physician
  • Valencia, CA
National Provider Identifier
1528883055
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
GOLDEN OAK DERMATOLOGY, P.C.
Doing business as
Golden Oak Dermatology, P.C.
Practice address
23823 Valencia Blvd Ste 150
Valencia, CA 91355-9509
Phone
(661) 380-7751
NPI assigned
Nov 19, 2024
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ronny C Choe, MS
Title
Practice Manager
Phone
(661) 380-7751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

23823 Valencia Blvd Ste 150
Valencia, CA 91355-9509

Mailing address

24307 Magic Mountain Pkwy Ste 313
Valencia, CA 91355-3402
Phone (661) 380-7751

Other names 1

  • Golden Oak Dermatology, P.C. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250113002972 CA Part B Supplier - Clinic/Group Practice 4880122266 Receives reassigned benefits from 1 practitioner
Practice locations: Valencia, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1528883055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24307 MAGIC MOUNTAIN PKWY STE 313",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913553402",
            "telephone_number": "661-380-7751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23823 VALENCIA BLVD STE 150",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913559509",
            "telephone_number": "661-380-7751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN OAK DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "CHOE",
        "authorized_official_first_name": "RONNY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "661-380-7751",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Oak Dermatology, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valencia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.