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

Last updated

Dec 20, 2014By the provider in NPPES

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, MDNPI 1902905664

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

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.

• Mavis Williams Billips, M.D.

  • Specialist
  • Los Angeles, CA
  • NPI 1902905664
  Authorized official Same address or phone

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 Fire Department Nurse Practitioner Program)
• City of Beverly Hills (City of Beverly Hills Fire Department)
• City View Surgery Center, LLC.
• CL Global Logistics LLC
• Clarion Vision Corporation

• Clinical Medical Laboratory in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• 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.