NPIMap

Organization Active NPI

Daniel E Gormley MD a Professional Corporation

  • Dermatology Physician
  • Glendora, CA
National Provider Identifier
1922101971
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A21148 Issued in CA
Legal business name
DANIEL E GORMLEY MD A PROFESSIONAL CORPORATION
Practice address
412 W Carroll Ave
Suite #207
Glendora, CA 91741-4280
Phone
(626) 963-7684
Fax
(626) 963-0575
NPI assigned
Sep 6, 2006
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Dr. Daniel E Gormley, MDNPI 1386629210
Title
Owner President
Phone
(626) 963-7684

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A21148 CA Primary
MOHS-Micrographic Surgery Physician 207ND0101X A21148 CA
Dermatopathology Physician 207ND0900X A21148 CA
Procedural Dermatology Physician 207NS0135X A21148 CA

Addresses

Primary practice location

412 W Carroll Ave
Suite #207
Glendora, CA 91741-4280

Mailing address

412 W Carroll Ave
Suite #207
Glendora, CA 91741-4280
Phone (626) 963-7684

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1922101971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE",
            "address_2": "SUITE #207",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414280",
            "telephone_number": "626-963-7684",
            "fax_number": "626-963-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE",
            "address_2": "SUITE #207",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414280",
            "telephone_number": "626-963-7684",
            "fax_number": "626-963-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL E GORMLEY MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "GORMLEY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "626-963-7684",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A21148",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A21148",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A21148",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A21148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.