NPIMap

Organization Active NPI

West Dermatology of Arizona, Inc

  • Dermatology Physician
  • Mesa, AZ
National Provider Identifier
1902850597
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
WEST DERMATOLOGY OF ARIZONA, INC
Practice address
560 W Brown Rd
Suite 4001
Mesa, AZ 85201-3221
Phone
(480) 962-4269
Fax
(480) 962-3702
NPI assigned
May 19, 2006
Last updated
Jan 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
J. Robert West Sr., M.D.
Title
President
Phone
(909) 335-8649

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

560 W Brown Rd
Suite 4001
Mesa, AZ 85201-3221

Mailing address

PO Box 2048
Redlands, CA 92373-0641
Phone (909) 335-8649

Other identifiers 1

IdentifierTypeStateIssuer
CS4930OtherAZRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

301 E Cottonwood Ln
Ste 1
Casa Grande, AZ 85122
Phone (520) 421-7100

Practitioners & affiliated clinicians

Practitioners 7

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1902850597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730641",
            "telephone_number": "909-335-8649",
            "fax_number": "909-335-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W BROWN RD",
            "address_2": "SUITE 4001",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013221",
            "telephone_number": "480-962-4269",
            "fax_number": "480-962-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST DERMATOLOGY OF ARIZONA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-335-8649",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS4930",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.