Corona Dermatology Center Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G044761 Issued in CA

Legal business name

CORONA DERMATOLOGY CENTER INC.

Practice address

1810 Fullerton Ave
Ste 101
Corona, CA 92881-3103

Phone

(951) 734-7900

Fax

(909) 860-2757

NPI assigned

Aug 20, 2006

Last updated

Jan 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Joy Fortich

Title

Billing Manager

Phone

(909) 860-7600

Specialties & licenses 5

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marshall Goldberg, D.D.S., M.S.D.

  • Dentist
  • Coos Bay, OR
  • NPI 1174557938
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1790890085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15807",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902091807",
            "telephone_number": "909-860-7600",
            "fax_number": "909-860-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 FULLERTON AVE",
            "address_2": "STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813103",
            "telephone_number": "951-734-7900",
            "fax_number": "909-860-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA DERMATOLOGY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "FORTICH",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "909-860-7600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G044761",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G044761",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G044761",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "G044761",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "G044761",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corona Advanced Imaging Center
• Corona Anesthesia Group, Inc.
• Corona Care Convalescent Corporation
• Corona Care Home, Inc.
• Corona Care LLC (Corona Health Care Center)
• Corona Drug,Inc. (Corona Drug)
• Corona Family Care Inc.
• Jaqueline Corona Godoy
• Corona Health Clinic, LLC
• Corona Health Specialty Associates, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.