Valley Dermatologic Medical Group, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A19349 Issued in CA

Legal business name

VALLEY DERMATOLOGIC MEDICAL GROUP, INC

Practice address

18364 Clark St
Tarzana, CA 91356-3502

Phone

(881) 345-7122

Fax

(818) 345-7448

NPI assigned

Jun 15, 2005

Organization subpart

No

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

Authorized official

Name

Donald R Seidman, MD

Title

President

Phone

(818) 345-7122

Specialties & licenses 1

Addresses

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

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel A Gross, MD

  • Procedural Dermatology Physician
  • Tarzana, CA
  • NPI 1396740056
  Medicare reassignment Care Compare group NPD
• Charles E Linden, MD

  • Procedural Dermatology Physician
  • Tarzana, CA
  • NPI 1508861634
  Medicare reassignment Care Compare group NPD
• Ada M Winkielman, MD

  • Dermatopathology Physician
  • Tarzana, CA
  • NPI 1992798870
  Medicare reassignment Care Compare group NPD
• Clayton T Hinshaw, MD

  • Procedural Dermatology Physician
  • Simi Valley, CA
  • NPI 1326043456
  Medicare reassignment NPD

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1699770719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18364 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563502",
            "telephone_number": "881-345-7122",
            "fax_number": "818-345-7448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18364 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563502",
            "telephone_number": "881-345-7122",
            "fax_number": "818-345-7448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY DERMATOLOGIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "SEIDMAN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-345-7122",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A19349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arash Vahdat, M.D
• Lillian Maria Vai, LCSW
• Samantha Kameron Valez, MA, RBT
• Valley Community Multicare Health Services
• Valley Corf, Inc.
• Valley Endoscopy Center LP
• Valley Foot & Ankle Center Inc.
• Valley Foot Surgeons, a Podiatry Group, Inc.
• Valley Heart and Rhythm Medical Inc
• Valley Home Health Care Agency, Inc.

• Dermatology Physician in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.