Advanced Dermatology & Skin Cancer Specialists

Primary specialty

Dermatology PhysicianTaxonomy code 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

Last updated

Nov 8, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jesse David Mitchell, M.D.

Title

President

Phone

(951) 303-6900

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 39

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.

• May Chhun, PA-C

  • Physician Assistant
  • Temecula, CA
  • NPI 1912638859

  Dermatology

  Medicare reassignment Care Compare group NPD
• Trevor M Dolling, PA

  • Physician Assistant
  • Manteca, CA
  • NPI 1457133738
  Medicare reassignment Care Compare group NPD
• Ana Alicia Fraga, FNP

  • Family Nurse Practitioner
  • Temecula, CA
  • NPI 1528661436
  Medicare reassignment Care Compare group NPD
• David Scott Johnson, M.D.

  • Surgery Physician
  • Coachella, CA
  • NPI 1104910306
  Medicare reassignment Care Compare group NPD
• Deborah Layton, N.P.

  • Dermatology Physician
  • Temecula, CA
  • NPI 1649444852
  Medicare reassignment Care Compare group NPD
• Ryan Jon Schoneboom

  • Physician Assistant
  • Stockton, CA
  • NPI 1962182030
  Medicare reassignment Care Compare group NPD
• Greg S Chance, PA-C

  • Surgical Physician Assistant
  • Yuba City, CA
  • NPI 1124074877
  Medicare reassignment Care Compare group
• Zekhariah Inyasio Idro, PA-C

  • Physician Assistant
  • Indio, CA
  • NPI 1922416023
  Medicare reassignment Care Compare group
• Jafar Koupaie, MD

  • Procedural Dermatology Physician
  • Riverside, CA
  • NPI 1508940644
  Medicare reassignment Care Compare group
• Christine Rosabelle Lee, PA-C

  • Physician Assistant
  • Stockton, CA
  • NPI 1538941638
  Medicare reassignment Care Compare group
• Tony Leuang

  • Medical Physician Assistant
  • Indio, CA
  • NPI 1265812374
  Medicare reassignment Care Compare group
• Caroline Delaine Levanovic, PA-C

  • Physician Assistant
  • Riverside, CA
  • NPI 1467317172
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1881023927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31720 TEMECULA PKWY",
            "address_2": "SUITE #203",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925802",
            "telephone_number": "951-303-6900",
            "fax_number": "951-303-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31720 TEMECULA PKWY",
            "address_2": "SUITE #203",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925802",
            "telephone_number": "951-303-6900",
            "fax_number": "951-303-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY & SKIN CANCER SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-303-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.