SOUTH BAY SKIN & CANCER MEDICAL GROUP, INC.
NPI 1033289574
Dermatology - Procedural Dermatology in Chula Vista, CA
About South Bay Skin & Cancer Medical Group, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH BAY SKIN & CANCER MEDICAL GROUP, INC. (NPI 1033289574) is a healthcare organization registered as a procedural dermatology in Chula Vista, California and active in the NPI registry since November 2006. The organization holds a CLIA Certificate of Compliance certificate valid through December 3, 2027 and lists Peter Paul Rullan, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
South Bay Skin & Cancer Medical Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to South Bay Skin & Cancer Medical Group, Inc., which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 05D0565938
South Bay Skin & Cancer Medical Group, Inc · Chula Vista, CAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is South Bay Skin & Cancer Medical Group, Inc.'s NPI number?
The NPI number for South Bay Skin & Cancer Medical Group, Inc. is 1033289574. It was assigned to this organization in the NPPES registry on November 9, 2006.
Where is South Bay Skin & Cancer Medical Group, Inc. located?
South Bay Skin & Cancer Medical Group, Inc. is located at 256 Landis Ave Third Floor, Chula Vista, CA 91910. The listed phone number is (619) 426-9600.
What is South Bay Skin & Cancer Medical Group, Inc.'s specialty?
The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.
Is South Bay Skin & Cancer Medical Group, Inc. enrolled in Medicare?
Yes. South Bay Skin & Cancer Medical Group, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through South Bay Skin & Cancer Medical Group, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Dermatology, reassign their Medicare billing to South Bay Skin & Cancer Medical Group, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does South Bay Skin & Cancer Medical Group, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 05D0565938) is associated with this NPI, valid through December 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for South Bay Skin & Cancer Medical Group, Inc. was last updated on March 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# South Bay Skin & Cancer Medical Group, Inc. · NPI 1033289574
Procedural Dermatology organization in Chula Vista, California. Organization record, active in the CMS NPPES registry since November 9, 2006.
## Identity
- **NPI:** 1033289574 (Entity type: Organization)
- **Enumerated:** November 9, 2006
- **Primary specialty:** Dermatology - Procedural Dermatology · taxonomy 207NS0135X
- **Organization subpart:** No
- **Authorized official:** Peter Rullan, MEDICAL DIRECTOR
## Practice location
- **Address:** 256 LANDIS AVE, THIRD FLOOR, Chula Vista, CA 91910-2650
- **Phone:** (619) 426-9600 · **Fax:** (619) 426-4112
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 14, 2022
- **Other identifiers:** Medicaid ZZZ73699Z (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1033289574) · Data from the CMS NPPES public registry.