Miremadi Dermatology Medical Corporation

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

A31016 Issued in CA

Legal business name

MIREMADI DERMATOLOGY MEDICAL CORPORATION

Practice address

7702 Ivanhoe Ave
La Jolla, CA 92037-4520

Phone

(858) 456-1840

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Arjang K Miremadi, M.D.NPI 1497849418

Title

Physician/Owner

Phone

(858) 456-1840

Specialties & licenses 4

Addresses

Other identifiers 1

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 1

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

• Arjang K Miremadi, MD

  • Dermatopathology Physician
  • La Jolla, CA
  • NPI 1497849418
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1760663116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 IVANHOE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374520",
            "telephone_number": "858-456-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 IVANHOE AVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920374520",
            "telephone_number": "858-456-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIREMADI DERMATOLOGY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "MIREMADI",
        "authorized_official_first_name": "ARJANG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "858-456-1840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A31016",
            "primary": true
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "CA",
            "license": "A31016",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A31016",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A31016",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A310160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minh Pham Dental Corporation (La Jolla Village Smiles Dentistry and Implants)
• Matthew John Minn
• Kimberly Minutella
• Gines D Miralles, M.D.
• Pedi Mirdamadi
• Arjang K Miremadi, MD
• Miriam Zabinsky Licensed Professional Clinical Counselor PC
• Ali Mirza, MD
• Michael Misel
• Mission Beach Holdings LLC (La Jolla Post-Acute)

• Dermatopathology Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.