NPIMap

Organization Active NPI

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

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1831938232
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
WILLIAM F RESH M.D. SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC
Practice address
5222 Balboa Ave # Floors5
San Diego, CA 92117-6904
Phone
(619) 267-8303
Fax
(619) 267-4835
NPI assigned
May 23, 2024
Organization subpart
Yes
Parent organization
WILLIAM F RESH M.D. SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Yareli Kelly Cifuentes
Title
Office Manager
Phone
(619) 267-8303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

5222 Balboa Ave # Floors5
San Diego, CA 92117-6904

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
This NPI is an additional NPI on the 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
05D2315219San Diego Family Dermatology5222 Balboa Ave, Floor 5, San Diego, CA 92117RegistrationDec 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
William F Resh MD Skin S4 organizations share this tax ID, including this one
Part of
William F Resh MD Skin S

Other organizations with this tax ID 3

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

Locations

1625 E Main St
Ste 103
El Cajon, CA 92021
Phone (619) 440-8433

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

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1831938232",
    "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": "5222 BALBOA AVE # FLOORS5",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176904",
            "telephone_number": "619-267-8303",
            "fax_number": "619-267-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM F RESH M.D. SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLIAM F RESH M.D. SKIN & SKIN CANCER MEDICAL GROUP OF SAN DIEGO, INC",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "CIFUENTES",
        "authorized_official_first_name": "YARELI",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "619-267-8303"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "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 San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.