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ADVANCED SKINCARE PHYSICIAN ASSISTANT CORPORATION (PAC)
NPI 1245830389
Physician Assistant in Fullerton, CA

Active since October 28, 2020
2720 N HARBOR BLVD STE 230, FULLERTON, CA 92835(714) 879-9936 Get Directions Write a Review

NPPES record last updated: February 8, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 8, 2021, Dec 28, 2020, Oct 28, 2020 (3 updates tracked since 2020).

About Advanced Skincare Physician Assistant Corporation (pac) NPPES

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

ADVANCED SKINCARE PHYSICIAN ASSISTANT CORPORATION (PAC) (NPI 1245830389), doing business as Advanced Skincare, Pac, is a healthcare organization registered as a physician assistant in Fullerton, California and active in the NPI registry since October 2020. The organization lists Suzanne Freesemann, Ceo, as its authorized official.

NPPES Registry Identity

NPI1245830389
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameADVANCED SKINCARE PHYSICIAN ASSISTANT CORPORATION (PAC)
Location Address2720 N HARBOR BLVD STE 230Fullerton, CA 92835-2626
Mailing Address2720 N Harbor Blvd Ste 230Fullerton, CA 92835-2626 · (714) 879-9936
Phone(714) 879-9936
Organization SubpartNo
Authorized OfficialSuzanne FreesemannCeo · (714) 879-9936
Enumeration DateOctober 28, 2020
Last NPPES UpdateFebruary 8, 20213 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2021
✔ NPI 1245830389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
2720 N HARBOR BLVD STE 230, Fullerton, CA 92835
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Other Names 1

Former Legal Business NameAdvanced Skincare, Pac

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Skincare Physician Assistant Corporation (pac) is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Advanced Skincare Physician Assistant Corporation (pac), which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Cole Fulwider, M.D.
Dermatology
NPI 1033188560
3772 KATELLA AVE. SUITE 206
Los Alamitos, CA 90720
(562) 430-4294
✔ PECOS✔ Accepts Medicare10 mi
Marguerite Critelli, MD
Dermatology
NPI 1902962954
1901 WESTCLIFF DR STE 2
Newport Beach, CA 92660
(949) 646-3376
✔ PECOS✔ Accepts Medicare19 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Skincare Physician Assistant Corporation (pac)'s NPI number?

The NPI number for Advanced Skincare Physician Assistant Corporation (pac) is 1245830389. It was assigned to this organization in the NPPES registry on October 28, 2020. The provider was formerly known as Advanced Skincare, Pac.

Where is Advanced Skincare Physician Assistant Corporation (pac) located?

Advanced Skincare Physician Assistant Corporation (pac) is located at 2720 N Harbor Blvd Ste 230, Fullerton, CA 92835. The listed phone number is (714) 879-9936.

What is Advanced Skincare Physician Assistant Corporation (pac)'s specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Advanced Skincare Physician Assistant Corporation (pac) enrolled in Medicare?

Yes. Advanced Skincare Physician Assistant Corporation (pac) is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Skincare Physician Assistant Corporation (pac)?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Advanced Skincare Physician Assistant Corporation (pac). 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Advanced Skincare Physician Assistant Corporation (pac) was last updated on February 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.