Spectrum Skin Cancer Care Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPECTRUM SKIN CANCER CARE INC

Practice address

425 E Holyoke PL
Claremont, CA 91711-1979

Phone

(909) 702-7602

NPI assigned

Jun 7, 2016

Organization subpart

No

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

Authorized official

Name

Asif Siddiq, M.D.

Title

President/Provider

Phone

(909) 702-7602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1790134047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865016",
            "telephone_number": "909-702-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E HOLYOKE PL",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917111979",
            "telephone_number": "909-702-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM SKIN CANCER CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "SIDDIQ",
        "authorized_official_first_name": "ASIF",
        "authorized_official_title_or_position": "PRESIDENT/PROVIDER",
        "authorized_official_telephone_number": "909-702-7602",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Claremont, CA
• Providers in Claremont, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.