Dermatology Pathology Medical Group, Inc

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

00A192080 Issued in CA

Legal business name

DERMATOLOGY PATHOLOGY MEDICAL GROUP, INC

Doing business as

American West Skin Pathology Consultation Service

Practice address

1007 Live Oak Blvd
Ste a-1
Yuba City, CA 95991-3454

Phone

(530) 673-3790

Fax

(530) 673-5642

NPI assigned

Sep 19, 2007

Last updated

Sep 19, 2007By the provider in NPPES

Organization subpart

Yes

Parent organization

DERMATOLOGY PATHOLOGY MEDICAL GROUP, INCAs reported in NPPES

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

Authorized official

Name

Dr. Leon Melvin Edelstein, M.D.NPI 1023177870

Title

President

Phone

(530) 673-3790

Specialties & licenses 11

Addresses

Other identifiers 1

Other names 1

• American West Skin Pathology Consultation Service Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Am W Skin Path Consulta

Locations

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.

• Leon Melvin Edelstein, M.D.

  • Dermatopathology Physician
  • Yuba City, CA
  • NPI 1023177870

  Allergy & Immunology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1548456825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 LIVE OAK BLVD",
            "address_2": "STE A-1",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913454",
            "telephone_number": "530-673-3790",
            "fax_number": "530-673-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 LIVE OAK BLVD",
            "address_2": "STE A-1",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959913454",
            "telephone_number": "530-673-3790",
            "fax_number": "530-673-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY PATHOLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOLOGY PATHOLOGY MEDICAL GROUP, INC",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "EDELSTEIN",
        "authorized_official_first_name": "LEON",
        "authorized_official_middle_name": "MELVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-673-3790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "00A192080",
            "primary": true
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "00A192080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A192080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American West Skin Pathology Consultation Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joy Dawn Denham, R.N., PHN
• Mickel Dana Denham, LVN
• Dennis G. Bechini, D.O. PC
• Gunvir Deol
• Licia Dering
• Alicia M Derrico
• Manpreet S Dev, DDS
• Justin Alexander Dew
• Gurbir S Dhaliwal, MD
• Harpreet Singh Dhaliwal

• Dermatopathology Physician in Yuba City, CA
• Providers in Yuba City, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.