Active NPI
Solano Dermatology Associates Inc
- Dermatology Physician
- El Cerrito, CA
National Provider Identifier
1962639583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- SOLANO DERMATOLOGY ASSOCIATES INC
- Practice address
- 6431 Fairmount Ave
Suite 3
El Cerrito, CA 94530-3655 - Phone
- (510) 527-8865
- Fax
- (510) 527-4123
- NPI assigned
- Jun 22, 2009
- Organization subpart
- Yes
- Parent organization
- SOLANO DERMATOLOGY ASSOCIATES INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Kevin Geisse, M.D.
- Title
- Owner
- Phone
- (707) 643-5785
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
6431 Fairmount Ave
Suite 3
El Cerrito, CA 94530-3655
Mailing address
2290 Sacramento St
Vallejo, CA 94590-2929
Phone (707) 643-5785
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0023150 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Solano Dermatology Asso
- Part of
- Solano Dermatology Asso
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dermatology Physician
- Saint Helena, CA
- NPI 1639491103
-
- Dermatology Physician
- Napa, CA
- NPI 1205342920
-
- Dermatology Physician
- Fairfield, CA
- NPI 1346488699
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1245628800000",
"number": "1962639583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2290 SACRAMENTO ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945902929",
"telephone_number": "707-643-5785",
"fax_number": "707-643-8190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6431 FAIRMOUNT AVE",
"address_2": "SUITE 3",
"city": "EL CERRITO",
"state": "CA",
"postal_code": "945303655",
"telephone_number": "510-527-8865",
"fax_number": "510-527-4123"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOLANO DERMATOLOGY ASSOCIATES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOLANO DERMATOLOGY ASSOCIATES INC",
"enumeration_date": "2009-06-22",
"last_updated": "2009-06-22",
"status": "A",
"authorized_official_last_name": "GEISSE",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "KEVIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "707-643-5785",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0023150",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Cerrito, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.