Organization Active NPI

California Dermatology and Mohs Surgery Specialists Inc

  • Dermatology Physician
  • Pasadena, CA
National Provider Identifier
1881316701
Registry record updated Mar 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CALIFORNIA DERMATOLOGY AND MOHS SURGERY SPECIALISTS INC
Practice address
50 Bellefontaine St Ste 202
Pasadena, CA 91105-3132
Phone
(818) 636-9039
NPI assigned
Sep 16, 2022
Last updated
Mar 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2026

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

Authorized official

Name
Mariah Ginn
Title
Authorized Credentialing Specialist
Phone
(805) 392-5138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

50 Bellefontaine St Ste 202
Pasadena, CA 91105-3132

Mailing address

50 Bellefontaine St Ste 202
Pasadena, CA 91105-3132

Other practice location 1

544 N Glendale Ave Ste B
Glendale, CA 91206-3311
Phone (818) 654-4791

Other practice location 2

120 Bellefontaine St
Pasadena, CA 91105-3102
Phone (626) 654-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230615000460 CA Part B Supplier - Clinic/Group Practice 0648638155 Receives reassigned benefits from 2 practitioners
Practice locations: Glendale, CA; Los Angeles, CA; Montrose, CA; Pasadena, CA

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
05D2278477California Dermatology and Mohs Surgery50 Bellefontaine St, Ste 202, Pasadena, CA 91105ComplianceMay 31, 2026

National Provider Directory

National Provider Directory

Locations

50 Bellefontaine St
Ste 202
Pasadena, CA 91105
Phone (626) 654-3376

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774137600000",
    "number": "1881316701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST STE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST STE 202",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "818-636-9039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "544 N Glendale Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912063311",
            "country_code": "US",
            "telephone_number": "818-654-4791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 Bellefontaine St",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911053102",
            "country_code": "US",
            "telephone_number": "626-654-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CALIFORNIA DERMATOLOGY AND MOHS SURGERY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A",
        "authorized_official_last_name": "GINN",
        "authorized_official_first_name": "MARIAH",
        "authorized_official_title_or_position": "AUTHORIZED CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "805-392-5138"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2026; 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.