Orange Coast Dermatology, Inc

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

A83696 Issued in CA

Legal business name

ORANGE COAST DERMATOLOGY, INC

Practice address

26732 Crown Valley Pkwy
Suite 461
Mission Viejo, CA 92691-6306

Phone

(949) 364-3305

Fax

(949) 347-1606

NPI assigned

Oct 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Daniel A Dicesare, M.D.NPI 1902859093

Title

President

Phone

(949) 888-8500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 6

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

• Daniel Andres Dicesare, M.D.

  • Procedural Dermatology Physician
  • Rancho Santa Margarita, CA
  • NPI 1902859093
  Medicare reassignment Care Compare group Authorized official
• Leela Athalye, D.O.

  • Dermatology Physician
  • Newport Beach, CA
  • NPI 1093097818
  Medicare reassignment Care Compare group NPD
• Jeffrey Keith Lander, M.D., PH.D.

  • Dermatology Physician
  • Irvine, CA
  • NPI 1174566046
  Medicare reassignment Care Compare group
• Amy Ngoc Nguyen, MD

  • Family Medicine Physician
  • Fullerton, CA
  • NPI 1548274996
  Medicare reassignment NPD
• Sahar Ghorany

  • Physician Assistant
  • Fullerton, CA
  • NPI 1720620883
  Medicare reassignment
• Jennifer Lynn Wong, M.D.

  • Family Medicine Physician
  • Orange, CA
  • NPI 1508835786
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254268800000",
    "number": "1790937647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34145 PACIFIC COAST HWY",
            "address_2": "# 670",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292808",
            "telephone_number": "949-888-8500",
            "fax_number": "949-888-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY",
            "address_2": "SUITE 461",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916306",
            "telephone_number": "949-364-3305",
            "fax_number": "949-347-1606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COAST DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2009-09-30",
        "status": "A",
        "authorized_official_last_name": "DICESARE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-888-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A83696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ben Behdad Omrani, D.D.S.
• Cheryl Oneil
• Michelle Suzanne Oneill, PPS
• Lorelei Marie Opene, PA-C
• Optometry 2020 (optometry at the shops)
• Orange County Children's Medical Group, Inc.
• Orange County Gi Hospitalists
• Orange County Neurology,Inc
• Orange County Neuropsychology, Inc.
• Orange County Orthopedic and Pain

• Procedural Dermatology Physician in Mission Viejo, CA
• Providers in Mission Viejo, 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 Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.