NPIMap

Organization Active NPI

Alamitos Dermatological Medical Clinic, Inc

Doing business as Coastal Dermatology and Plastic Surgery

  • Specialist
  • Huntington Beach, CA
National Provider Identifier
1588911549
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ALAMITOS DERMATOLOGICAL MEDICAL CLINIC, INC
Doing business as
Coastal Dermatology and Plastic Surgery
Practice address
17822 Beach Blvd
Suite 427
Huntington Beach, CA 92647-7101
Phone
(714) 842-7796
Fax
(714) 842-9206
NPI assigned
Aug 9, 2012
Last updated
Aug 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Authorized official

Name
Dr. Matthew Bart Luxenberg, M.D.NPI 1548353121
Title
Secretary/Treasurer
Phone
(562) 598-8593

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

17822 Beach Blvd
Suite 427
Huntington Beach, CA 92647-7101

Mailing address

3801 Katella Ave
Suite 101
Los Alamitos, CA 90720-3338
Phone (562) 598-8593

Other names 1

  • Coastal Dermatology and Plastic Surgery Doing business as

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344470400000",
    "number": "1588911549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 KATELLA AVE",
            "address_2": "SUITE 101",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203338",
            "telephone_number": "562-598-8593",
            "fax_number": "562-594-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17822 BEACH BLVD",
            "address_2": "SUITE 427",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926477101",
            "telephone_number": "714-842-7796",
            "fax_number": "714-842-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMITOS DERMATOLOGICAL MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A",
        "authorized_official_last_name": "LUXENBERG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "BART",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "562-598-8593",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Dermatology and Plastic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.