Individual provider Active NPI

Christopher Tomassian, MD

  • Dermatology Physician
  • Glendora, CA
National Provider Identifier
1871097550
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
177939 Issued in CA
Practice address
552 W Foothill Blvd Ste 202
Glendora, CA 91741-2470
Phone
(818) 795-8252
NPI assigned
Mar 19, 2018
Last updated
Aug 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 177939 CA Primary
Procedural Dermatology Physician 207NS0135X 177939 CA

Addresses

Primary practice location

552 W Foothill Blvd Ste 202
Glendora, CA 91741-2470

Mailing address

552 W Foothill Blvd Ste 202
Glendora, CA 91741-2470
Phone (626) 240-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926000357 CA Practitioner - Dermatology 8921333626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Missouri, Kansas City, School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Collective IncGroup PAC ID 8729463914, 3 clinicians

Practice addresses (Care Compare)

552 W Foothill Blvd
Suite 202
Glendora, CA 91741-2470
Phone (818) 795-8252

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions576
Removal of skin cancer1-10
Skin biopsy166

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
177939CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Collective Inc Dermatology CurrentSince Jun 27, 2022 Accepting new patients

Locations

9400 Brighton Way
Ste 404
Beverly Hills, CA 90210
Phone (310) 278-2940

552 W Foothill Blvd
Ste 202
Glendora, CA 91741
Phone (626) 240-2020

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1871097550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 W FOOTHILL BLVD STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412470",
            "telephone_number": "626-240-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 W FOOTHILL BLVD STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412470",
            "telephone_number": "818-795-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMASSIAN",
        "first_name": "CHRISTOPHER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "177939",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "177939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.