NPIMap

Organization Active NPI

Boston Medical and Surgical Dermatology

  • Dermatology Physician
  • Covina, CA
National Provider Identifier
1972799815
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A74086 Issued in CA
Legal business name
BOSTON MEDICAL AND SURGICAL DERMATOLOGY
Practice address
247 W San Bernardino Rd
Covina, CA 91723-1516
Phone
(626) 653-2525
Fax
(626) 967-3775
NPI assigned
Sep 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Saeed Nawaz Jaffer, M.D.
Title
Owner
Phone
(626) 653-2525

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X A74086 CA Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X A74086 CA
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X A74086 CA
Pediatric Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NP0225X A74086 CA
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X A74086 CA

Addresses

Primary practice location

247 W San Bernardino Rd
Covina, CA 91723-1516

Mailing address

247 W San Bernardino Rd
Covina, CA 91723-1516
Phone (626) 653-2525

Other names 1

  • Boston Dermatology Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1972799815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231516",
            "telephone_number": "626-653-2525",
            "fax_number": "626-967-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231516",
            "telephone_number": "626-653-2525",
            "fax_number": "626-967-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MEDICAL AND SURGICAL DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "JAFFER",
        "authorized_official_first_name": "SAEED",
        "authorized_official_middle_name": "NAWAZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-653-2525",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A74086",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A74086",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A74086",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A74086",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A74086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boston Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.