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ADVANCED DERMATOLOGY SURGICAL AND MEDICAL GROUP INC.
NPI 1154407856
Dermatology in Lakewood, CA

Active since October 27, 2006CLIA 05D0718779 · Certificate of Compliance
3650 E SOUTH ST, #306, LAKEWOOD, CA 90712(562) 633-6353(562) 633-4996 Get Directions Write a Review

NPPES record last updated: December 2, 2025. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Advanced Dermatology Surgical And Medical Group Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADVANCED DERMATOLOGY SURGICAL AND MEDICAL GROUP INC. (NPI 1154407856) is a healthcare organization registered as a dermatology in Lakewood, California and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through September 30, 2026 and lists Fredric Robert Rosenberg, Owner, as its authorized official.

NPPES Registry Identity

NPI1154407856
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY SURGICAL AND MEDICAL GROUP INC.
Location Address3650 E SOUTH ST, #306Lakewood, CA 90712
Mailing Address3650 E South St, #306Lakewood, CA 90712 · (562) 633-6353 · Fax (562) 633-4996
Phone(562) 633-6353
Fax(562) 633-4996
Organization SubpartNo
Authorized OfficialFredric Robert RosenbergOwner · (562) 633-6353
Enumeration DateOctober 27, 2006
Last NPPES UpdateDecember 2, 2025
NPPES CertifiedDecember 2, 2025
✔ NPI 1154407856 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
3650 E SOUTH ST, Lakewood, CA 90712
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Other Identifiers 5

MedicaidGR0025890CA
OtherG21402CA · Great-west
Other4024334CA · Aetna
OtherG21402CA · Blue Cross
OtherZZZ12556ZCA · Blue Shield

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 05D0718779

Advanced Dermatology Surgery And Medical Group · Lakewood, CA
Active · expires Sep 30, 2026
CLIA Number05D0718779
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2022
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorFredric R. Rosenberg MD
Laboratory Phone(562) 633-6353
Laboratory LocationAdvanced Dermatology Surgery And Medical Group3650 E South St Ste 306, Lakewood, CA 90712
CLIA data matches this NPI record on: Address Phone
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 3

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

KARTIK THAKER M.D.
Internal Medicine (Cardiovascular Disease)
3650 E SOUTH ST, SUITE # 210
LAKEWOOD, CA 90712
Los Angeles County (562) 630-2360
TOP PHARMACY, INC
Pharmacy (Community/Retail Pharmacy)
3650 E SOUTH ST, STE 100
LAKEWOOD, CA 90712
Los Angeles County (562) 633-1150
ISAAC EISENSTEIN MD A PROF CORP
Internal Medicine (Cardiovascular Disease)
3650 E SOUTH ST, #310
LAKEWOOD, CA 90712
Los Angeles County (562) 531-1980

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 Advanced Dermatology Surgical And Medical Group Inc.'s NPI number?

The NPI number for Advanced Dermatology Surgical And Medical Group Inc. is 1154407856. It was assigned to this organization in the NPPES registry on October 27, 2006.

Where is Advanced Dermatology Surgical And Medical Group Inc. located?

Advanced Dermatology Surgical And Medical Group Inc. is located at 3650 E South St #306, Lakewood, CA 90712. The listed phone number is (562) 633-6353.

What is Advanced Dermatology Surgical And Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Advanced Dermatology Surgical And Medical Group Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0718779) is associated with this NPI, valid through September 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology Surgical And Medical Group Inc. was last updated on December 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.