Seaside Dermatology, Inc.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

A104847 Issued in CA

Legal business name

SEASIDE DERMATOLOGY, INC.

Practice address

4950 Barranca Pkwy
Suite 307
Irvine, CA 92604-4671

Phone

(949) 552-1313

NPI assigned

Apr 28, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Hien Thanh Tran, M.D.-PH.D.NPI 1487851408

Title

Ceo

Phone

(949) 278-2209

Specialties & licenses 1

Addresses

Other names 1

• Seaside Dermatology and Skin Cancer Center 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

Locations

Practitioners 2

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

• Hien Thanh Tran, M.D.-PH.D.

  • Dermatology Physician
  • Irvine, CA
  • NPI 1487851408
  Medicare reassignment Care Compare group Authorized official
• Leela Athalye, D.O.

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1093097818
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1710245634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 BARRANCA PKWY STE 307",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 BARRANCA PKWY",
            "address_2": "SUITE 307",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044671",
            "telephone_number": "949-552-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE DERMATOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-28",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "HIEN",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-278-2209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.-PH.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A104847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Dermatology and Skin Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seaside Dermatology and Skin Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Scott, DC
• Scottsdale Medical Billing Solutions LLC
• Sean Seal-Horowitz, HIS
• Letitia Ariel Seales
• Sean Wonhyung Chang
• Ryan Seay, PH.D.
• Olga Secgin-Valentine
• Cyrus Sharuz Sedaghat, MD
• Mona Sedghian, MD
• Dorsa Sedighi

• MOHS-Micrographic Surgery Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• MOHS-Micrographic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.