Carlson Surgical Dermatology Corp

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CARLSON SURGICAL DERMATOLOGY CORP

Doing business as

California Center for Dermatologic Surgery

Practice address

2100 Webster St Ste 506
San Francisco, CA 94115-2381

Phone

(415) 226-9431

NPI assigned

Apr 10, 2022

Last updated

Apr 10, 2022By 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

Ekama Carlson, MDNPI 1245532159

Title

Owner

Phone

(415) 226-9431

Specialties & licenses 1

Addresses

Other names 1

• California Center for Dermatologic Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Ekama Carlson, MD, PHD

  • MOHS-Micrographic Surgery Physician
  • San Francisco, CA
  • NPI 1245532159

  Dermatology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649548800000",
    "number": "1912649096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 506",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152381",
            "telephone_number": "415-226-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 506",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152381",
            "telephone_number": "415-226-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLSON SURGICAL DERMATOLOGY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-10",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "EKAMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-226-9431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "California Center for Dermatologic Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Anthony Carlos, M.D.
• Claudia Carlos
• David Carlos, BSN RN
• Julieta Jay Carlos, D.M.D.
• Nebio Carlos
• Brian James Carlson, MD
• Ekama Carlson, MD, PHD
• Elle Carlson, DPT
• Laurie Lynn Carlson, RN, MSN
• Oliver Carlson

• Dermatology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2022; 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.