Organization Active NPI

Enhanced Dermatology of Orange County

  • Dermatology Physician
  • Tustin, CA
National Provider Identifier
1659221281
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ENHANCED DERMATOLOGY OF ORANGE COUNTY
Practice address
17601 17TH St Ste 110
Tustin, CA 92780-1949
Phone
(714) 790-0005
Fax
(714) 699-2444
NPI assigned
Feb 2, 2026
Last updated
Jul 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Authorized official

Name
Lisa Lefevre
Title
Biller
Phone
(951) 441-4113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

17601 17TH St Ste 110
Tustin, CA 92780-1949

Mailing address

17601 17TH St Ste 110
Tustin, CA 92780-1949
Phone (714) 790-0005

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1769990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1659221281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-699-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 110",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801949",
            "telephone_number": "714-790-0005",
            "fax_number": "714-699-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED DERMATOLOGY OF ORANGE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "LEFEVRE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "951-441-4113"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

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