Active NPI
Daniel Carl Dwyer, M.D.
- Dermatology Physician
- Costa Mesa, CA
National Provider Identifier
1992889232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G38229
- Practice address
- 275 Victoria St
Suite 2-H
Costa Mesa, CA 92627-1906 - Phone
- (949) 631-1051
- Fax
- (949) 631-1052
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | G38229 | CA | Primary |
Addresses
Primary practice location
275 Victoria St
Suite 2-H
Costa Mesa, CA 92627-1906
Mailing address
275 Victoria Street
Suite 2-H
Costa Mesa, CA 92627-1906
Phone (949) 631-1051
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G38229 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles ENT Facial Plastics Center, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Medical Specialty Clinic/Center
- Redondo Beach, CA
- NPI 1225463797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992889232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "275 VICTORIA STREET",
"address_2": "SUITE 2-H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-631-1051",
"fax_number": "949-631-1052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "275 VICTORIA ST",
"address_2": "SUITE 2-H",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926271906",
"telephone_number": "949-631-1051",
"fax_number": "949-631-1052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWYER",
"first_name": "DANIEL",
"middle_name": "CARL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G38229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.