NPIMap

Organization Active NPI

William F Resh MD, Skin & Skin Cancer Medical Group of San Diego, Inc.

Doing business as San Diego Family Dermatology

  • Specialist
  • National City, CA
National Provider Identifier
1790973162
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
WILLIAM F RESH MD, SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC.
Doing business as
San Diego Family Dermatology
Practice address
655 Euclid Ave Ste 304
National City, CA 91950-2974
Phone
(619) 267-8303
Fax
(619) 267-4835
NPI assigned
Oct 10, 2007
Last updated
Jun 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Brooke Resh Sateesh, M.D.NPI 1164565339
Title
Owner
Phone
(619) 267-8303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

655 Euclid Ave Ste 304
National City, CA 91950-2974

Mailing address

655 Euclid Ave Ste 304
National City, CA 91950-2974
Phone (619) 267-8303

Other names 1

  • San Diego Family Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430000629 CA Part B Supplier - Clinic/Group Practice 4082601935 Receives reassigned benefits from 18 practitioners
3 other NPIs on this enrollment
Practice locations: Poway, CA; San Diego, CA; National City, CA; El Cajon, CA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2115868San Diego Family Dermatology655 Euclid Ave, Ste 304, National City, CA 91950ComplianceApr 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
William F Resh MD Skin4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5222 Balboa Ave
Fl 5
San Diego, CA 92117
Phone (619) 267-8303

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1790973162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE STE 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502974",
            "telephone_number": "619-267-8303",
            "fax_number": "619-267-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 EUCLID AVE STE 304",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502974",
            "telephone_number": "619-267-8303",
            "fax_number": "619-267-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM F RESH MD, SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "SATEESH",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "RESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-267-8303",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Diego Family Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.