Advanced Dermatology & Skin Cancer Specialists
Organization Active NPI Dermatology Physician · Temecula, CA
NPI 1881023927 · NPPES record last updated Nov 8, 2013
Key facts
- NPI
- 1881023927
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- ADVANCED DERMATOLOGY & SKIN CANCER SPECIALISTS
- Practice address
- 31720 Temecula Pkwy
Suite #203
Temecula, CA 92592-5802 - Phone
- (951) 303-6900
- Fax
- (951) 303-2900
- NPI assigned
- Nov 8, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Jesse David Mitchell, M.D.
- Title
- President
- Phone
- (951) 303-6900
Practitioners 39
-
May Chhun, PA-C
-
Trevor M Dolling, PA
-
Ana Alicia Fraga, FNP
-
David Scott Johnson, M.D.
-
Deborah Layton, N.P.
-
Greg S Chance, PA-C
-
Zekhariah Inyasio Idro, PA-C
-
Jafar Koupaie, MD
-
Christine Rosabelle Lee, PA-C
-
Chad Sweetnam, PA-C
-
Isha Saeeda Taylor, PHYSICIAN ASSISTANT
-
Isabella Ariana Will, PA-C
-
Reeta Roomeal Zamro, PA-C
-
Cassidy Hedrick, PA
-
Andrea D. Avery, MD
-
Orlanda Maglasang Catacutan, MSN FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140131000433 | CA | Part B Supplier - Clinic/Group Practice | 3678702206 |
Receives reassigned benefits from 18 practitioners Practice locations: Riverside, CA; Yuba City, CA; Victorville, CA; Temecula, CA; Stockton, CA; Palm Springs, CA; Murrieta, CA; Menifee, CA… |
National Provider Directory
Locations
3989 W Stetson Ave
Ste 201
Hemet, CA 92545
Phone (951) 302-4700
3853 W Stetson Ave
Ste 201
Hemet, CA 92545
Phone (951) 929-3376
3989 W Stetson Ave
Ste 200
Hemet, CA 92545
Phone (951) 306-3120
47647 Caleo Bay Dr
Ste 120
La Quinta, CA 92253
Phone (760) 564-8200
29826 Haun Rd
Ste 306
Menifee, CA 92586
Phone (951) 566-5634
1180 N Indian Canyon Dr
Ste E315
Palm Springs, CA 92262
Phone (760) 832-6277
8990 Garfield St
Ste 3
Riverside, CA 92503
Phone (909) 689-4431
31150 Temecula Pkwy
Ste 337
Temecula, CA 92592
31150 Temecula Pkwy
Ste 104
Temecula, CA 92592
Phone (951) 303-2100
12637 Hesperia Rd
Ste C
Victorville, CA 92395
Phone (442) 255-4130
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| MOHS-Micrographic Surgery Physician |
207ND0101X | |||
| Pediatric Dermatology Physician |
207NP0225X | |||
| Procedural Dermatology Physician |
207NS0135X |
Addresses
Primary practice location
31720 Temecula Pkwy
Suite #203
Temecula, CA 92592-5802
Mailing address
31720 Temecula Pkwy
Suite #203
Temecula, CA 92592-5802
Phone (951) 303-6900
Other providers in Temecula, CA
- Joell Lynne Adkins
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- Emily Adner
- Advance Speech & Language Professional Services Inc .
- Advanced Chiropractic
- Advanced Institute for Plastic Surgery Inc
- Advanced Management Practice Physician Assistant Corporation
- Advanced Orthopaedic Surgery Center
- Advanced Traditional Acupuncture
- Advanta Senior Care, Inc
All providers in Temecula, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.