Organization Active NPI

Preferred Dermatology Physician Assistant Corporation

Doing business as Hadfield Dermatology, A Physician Assistant Corporation

  • Medical Physician Assistant
  • Lakeport, CA
National Provider Identifier
1639088594
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
PREFERRED DERMATOLOGY PHYSICIAN ASSISTANT CORPORATION
Doing business as
Hadfield Dermatology, A Physician Assistant Corporation
Practice address
475 N Forbes St Ste B
Lakeport, CA 95453-4725
Phone
(707) 606-6366
NPI assigned
Sep 4, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Greg Hadfield, PHYSICIAN ASSISTANT
Title
President
Phone
(707) 606-6636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

475 N Forbes St Ste B
Lakeport, CA 95453-4725

Mailing address

40 Clearlake Ave
Lakeport, CA 95453-3817
Phone (760) 709-1255

Other names 1

  • Hadfield Dermatology, A Physician Assistant Corporation Doing business as

National Provider Directory

National Provider Directory

Locations

475 N Forbes St
Ste B
Lakeport, CA 95453

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": "1788480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1639088594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CLEARLAKE AVE",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954533817",
            "telephone_number": "760-709-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 N FORBES ST STE B",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954534725",
            "telephone_number": "707-606-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED DERMATOLOGY PHYSICIAN ASSISTANT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "HADFIELD",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-606-6636",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hadfield Dermatology, A Physician Assistant Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.