NPI Code Detail JSON Logo

1164532339 NPI number — DERMATOLOGY INSTITUTE & SKIN CARE CENTER, INC.

NPI Number: 1164532339
Health Care Provider/Practitioner: DERMATOLOGY INSTITUTE & SKIN CARE CENTER, INC.

Information about “1164532339” NPI (DERMATOLOGY INSTITUTE & SKIN CARE CENTER, INC.) exists in 1164532339 in HTML format HTML  |  1164532339 in plain Text format TXT  |  1164532339 in PDF (Portable Document Format) PDF  |  1164532339 in an XML format XML  formats.

NPI Number : 1164532339 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1164532339",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "DERMATOLOGY INSTITUTE & SKIN CARE CENTER, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2001 SANTA MONICA BLVD",
    "SecondLineMailingAddress": "#1160W",
    "MailingAddressCityName": "SANTA MONICA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90404-2102",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-829-4104",
    "MailingAddressFaxNumber": "310-829-4150",
    "FirstLinePracticeLocationAddress": "2001 SANTA MONICA BLVD",
    "SecondLinePracticeLocationAddress": "#1160W",
    "PracticeLocationAddressCityName": "SANTA MONICA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90404-2102",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-829-4104",
    "PracticeLocationAddressFaxNumber": "310-829-4150",
    "EnumerationDate": "08/30/2006",
    "LastUpdateDate": "02/02/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PARTIDA",
    "AuthorizedOfficialFirstName": "VERONICA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRACTICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "310-829-4104",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207N00000X",
        "TaxonomyName": "Dermatology Physician",
        "LicenseNumber": "A53239",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.