GOLDEN COAST DERMATOLOGY, SKIN CANCER AND VEIN CENTER PC
NPI 1053957456
Dermatology - MOHS-Micrographic Surgery in Mission Viejo, CA
NPI Status: Active since November 20, 2019
Contact Information
26732 CROWN VALLEY PKWY STE 571
MISSION VIEJO, CA
ZIP 92691
Phone: (270) 933-2109
- Organization
- Dermatology
- MOHS-Micrographic Surgery
- CLIA Number: 05D2182444
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-08-2027
About GOLDEN COAST DERMATOLOGY, SKIN CANCER AND VEIN CENTER PC
This page provides the complete NPI Profile along with additional information for Golden Coast Dermatology, Skin Cancer And Vein Center Pc, a provider established in Mission Viejo, California operating as a Dermatology, focusing in mohs-micrographic surgery . The healthcare provider is registered in the NPI registry with number 1053957456 assigned on November 2019. The practitioner's primary taxonomy code is 207ND0101X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Golden Coast Dermatology, Skin Cancer And Vein Center Pc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is William Tidwell Md (Owner/physician)
- NPI
- 1053957456
- Provider Name
- GOLDEN COAST DERMATOLOGY, SKIN CANCER AND VEIN CENTER PC
- Entity Type
- Organization
- Location Address
- 26732 CROWN VALLEY PKWY STE 571 MISSION VIEJO, CA 92691
- Location Phone
- (270) 933-2109
- Mailing Address
- 26732 CROWN VALLEY PKWY STE 571 MISSION VIEJO, CA 92691
- Mailing Phone
- (270) 933-2109
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-20-2019
- Last Update Date
- 03-27-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology MOHS-Micrographic Surgery
- Taxonomy Code
- 207ND0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| A147575 | OTHER (01) | CA | CA STATE LICENSE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2182444
- Facility Type
- Physician Office
- Certificate Effective Date
- September 09, 2025
- Certificate Expiration Date
- September 08, 2027
- Laboratory Director
- DR. JESSICA Y. KIM
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Golden Coast Dermatology, Skin Cancer And Vein Center Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1053957456, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1053957456, enumerated as an "organization" on November 20, 2019.
The provider is located at 26732 CROWN VALLEY PKWY STE 571 MISSION VIEJO, CA 92691 and the phone number is (270) 933-2109.
Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
