NPIMap

Organization Active NPI

Bayside Dermatology Incorporated

  • Dermatology Physician
  • San Diego, CA
National Provider Identifier
1982803821
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A79823 Issued in CA
Legal business name
BAYSIDE DERMATOLOGY INCORPORATED
Practice address
8174 Regents Rd Apt 303
San Diego, CA 92122-1371
Phone
(858) 552-8096
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Bryan Chen, M.D.
Title
Owner
Phone
(858) 552-8096

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X A79823 CA Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X A79823 CA
Dermatopathology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0900X A79823 CA
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NI0002X A79823 CA
Pediatric Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NP0225X A79823 CA
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X A79823 CA

Addresses

Primary practice location

8174 Regents Rd Apt 303
San Diego, CA 92122-1371

Mailing address

8174 Regents Rd Apt 303
San Diego, CA 92122-1371

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1982803821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8174 REGENTS RD APT 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8174 REGENTS RD APT 303",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221371",
            "telephone_number": "858-552-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE DERMATOLOGY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-552-8096",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A79823",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A79823",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A79823",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "CA",
            "license": "A79823",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "CA",
            "license": "A79823",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A79823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.