John K Nylund MD Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

C34111 Issued in CA

Legal business name

JOHN K NYLUND MD INC

Doing business as

So Bay Dermatology

Practice address

14650 Aviation Blvd
Suite 235
Hawthorne, CA 90250-6656

Phone

(310) 643-9333

Fax

(310) 643-9337

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Andi V Nylund

Title

Office MGR

Phone

(310) 643-9333

Specialties & licenses 1

Addresses

Other names 1

• So Bay Dermatology Doing business as

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811949902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD",
            "address_2": "SUITE 235",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506656",
            "telephone_number": "310-643-9333",
            "fax_number": "310-643-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 AVIATION BLVD",
            "address_2": "SUITE 235",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902506656",
            "telephone_number": "310-643-9333",
            "fax_number": "310-643-9337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN K NYLUND MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NYLUND",
        "authorized_official_first_name": "ANDI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "310-643-9333",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C34111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "So Bay Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nsreen Jesri
• Jiakai Ji, MD
• Mayda Jimenez
• Raymond Jing, MD
• John E. Maanum, O.D.
• Karlon Howard Johnson, M.D.
• Marcus Johnson
• Deshellia Jones
• Crystal Mae Jordan
• Jose R Sardinas

• Dermatology Physician in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• 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.