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SOUTH BAY SKIN & CANCER MEDICAL GROUP, INC.
NPI 1033289574
Dermatology - Procedural Dermatology in Chula Vista, CA

Active since November 09, 2006CLIA 05D0565938 · Certificate of Compliance
256 LANDIS AVE, THIRD FLOOR, CHULA VISTA, CA 91910(619) 426-9600(619) 426-4112 Get Directions Write a Review

NPPES record last updated: March 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1033289574
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameSOUTH BAY SKIN & CANCER MEDICAL GROUP, INC.
Location Address256 LANDIS AVE, THIRD FLOORChula Vista, CA 91910-2650
Mailing Address256 Landis Ave, Third FloorChula Vista, CA 91910-2650 · (619) 426-9600 · Fax (619) 426-4112
Phone(619) 426-9600
Fax(619) 426-4112
Organization SubpartNo
Authorized OfficialPeter Paul RullanMedical Director · (619) 426-9600
Enumeration DateNovember 9, 2006
Last NPPES UpdateMarch 14, 2022
NPPES CertifiedMarch 14, 2022
✔ NPI 1033289574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in CA · G42243
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
256 LANDIS AVE, Chula Vista, CA 91910
Open in Google Maps ↗

Other Identifiers 1

MedicaidZZZ73699ZCA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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, CA
Active · expires Dec 3, 2027
CLIA Number05D0565938
Laboratory TypePhysician Office
Certificate Effective DateDecember 4, 2025
Certificate Expiration DateDecember 3, 2027
Laboratory DirectorPeter P. Rullan MD
Laboratory Phone(619) 426-1233
Laboratory LocationSouth Bay Skin & Cancer Medical Group, Inc256 Landis Ave Ste 300, Chula Vista, CA 91910
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. CARLOS FERNANDO VALLBONA PA-C
Physician Assistant
256 LANDIS AVE, 3RD FLOOR
CHULA VISTA, CA 91910
San Diego County (619) 426-9600
DR. PETER P RULLAN M.D.
Dermatology (Procedural Dermatology)
256 LANDIS AVE, 3RD FLOOR
CHULA VISTA, CA 91910
San Diego County (619) 426-9600
JENNIFER RULLAN MD
Dermatology
256 LANDIS AVE, SUITE 300
CHULA VISTA, CA 91910
San Diego County (619) 422-1233
ELITE SPECIALTY SURGERY CENTER OF CHULA VISTA, LLC
Surgery (Vascular Surgery)
256 LANDIS AVE
CHULA VISTA, CA 91910
San Diego County (619) 616-7641
CHARLES E BOWER MD INC
Family Medicine
256 LANDIS AVE, STE 200
CHULA VISTA, CA 91910
San Diego County (619) 427-0652

Frequently 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.

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.