Woodglen Institute of Aesthetics and Dermatology

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

WOODGLEN INSTITUTE OF AESTHETICS AND DERMATOLOGY

Practice address

541 S Pasadena Ave
201
Glendora, CA 91741-6232

Phone

(626) 852-0599

Fax

(626) 852-0010

NPI assigned

May 3, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Vickie S Emry

Title

Admin Asst

Phone

(626) 963-4124

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780642967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 S PASADENA AVE",
            "address_2": "201",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917416232",
            "telephone_number": "626-852-0599",
            "fax_number": "626-852-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S PASADENA AVE",
            "address_2": "201",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917416232",
            "telephone_number": "626-852-0599",
            "fax_number": "626-852-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODGLEN INSTITUTE OF AESTHETICS AND DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EMRY",
        "authorized_official_first_name": "VICKIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMIN ASST",
        "authorized_official_telephone_number": "626-963-4124",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Procedural Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.