City of Angels Dermatology Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLM 000346988 Issued in CA

Legal business name

CITY OF ANGELS DERMATOLOGY INC

Practice address

435 N Roxbury Dr Ste 207
Beverly Hills, CA 90210-5004

Phone

(310) 651-8240

Fax

(310) 651-8254

NPI assigned

Dec 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Mavis W Billips, MD

Title

Director

Phone

(310) 651-8240

Specialties & licenses 1

Addresses

Tax ID family

City of Angels Dermatology Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• City of Angels Dermatology Inc

  • Clinical Medical Laboratory
  • Long Beach, CA
  • NPI 1710385901
  NPD tax ID

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

{
    "created_epoch": "1419033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419033600000",
    "number": "1992103188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY # 665",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-651-8240",
            "fax_number": "310-651-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N ROXBURY DR STE 207",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902105004",
            "telephone_number": "310-651-8240",
            "fax_number": "310-651-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ANGELS DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-20",
        "last_updated": "2014-12-20",
        "status": "A",
        "authorized_official_last_name": "BILLIPS",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-651-8240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLM 000346988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sera Chung, PHARM D, RPH
• Michael Missak Churukian, M.D.
• Viktoria Cicolli, PSYD
• Cienega Spa
• Guy Citrin, N.D.
• City of Beverly Hills
• City of Beverly Hills
• City View Surgery Center, LLC.
• CL Global Logistics LLC
• Clarion Vision Corporation

• All providers in Beverly Hills, CA
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2014; 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.