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BEACH CITIES DEMATOLOGY MED CENTER
NPI 1326119165
Dermatology in Redondo Beach, CA

Active since November 13, 2006CLIA 05D0694537 · Certificate of Compliance
520 N PROSPECT AVE, STE 302, REDONDO BEACH, CA 90277(310) 798-1515(310) 798-3131 Get Directions Write a Review

NPPES record last updated: March 24, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 10, 2022, Mar 4, 2022 (2 updates tracked since 2022).

About Beach Cities Dematology Med Center NPPES

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

BEACH CITIES DEMATOLOGY MED CENTER (NPI 1326119165) is a healthcare organization registered as a dermatology in Redondo Beach, California and active in the NPI registry since November 2006. The organization holds a CLIA Certificate of Compliance certificate valid through July 13, 2027 and lists Neal M Ammar, Ceo, as its authorized official.

NPPES Registry Identity

NPI1326119165
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameWILLIAM J WICKWIRE M D INC A PROFESSIONAL CORPORATION
Location Address520 N PROSPECT AVE, STE 302Redondo Beach, CA 90277-3041
Mailing Address520 N Prospect Ave, Ste 302Redondo Beach, CA 90277-3041 · (310) 798-1515 · Fax (310) 798-3131
Phone(310) 798-1515
Fax(310) 798-3131
Organization SubpartNo
Authorized OfficialNeal M AmmarCeo · (310) 798-1515
Enumeration DateNovember 13, 2006
Last NPPES UpdateMarch 24, 20222 updates tracked since enumeration
NPPES CertifiedMarch 24, 2022
✔ NPI 1326119165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · G650830
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.
520 N PROSPECT AVE, Redondo Beach, CA 90277
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Other Names 1

Doing Business AsBeach Cities Dematology Med Center

Other Identifiers 2

Other00G650830CA · Medicare Northern Ca Id
Medicaid00G650830CA

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 2

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 05D0694537

William J Wickwire, MD Inc · Redondo Beach, CA
Active · expires Jul 13, 2027
CLIA Number05D0694537
Laboratory TypePhysician Office
Certificate Effective DateJuly 14, 2025
Certificate Expiration DateJuly 13, 2027
Laboratory DirectorWilliam J. Wickwire MD
Laboratory Phone(310) 798-1515
Laboratory LocationWilliam J Wickwire, MD Inc520 N Prospect Ave, Ste 302, Redondo Beach, CA 90277
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.

Certificate of Compliance 05D1099142

William J Wickwire, MD Inc · Culver City, CA
Expired · Jul 31, 2026
CLIA Number05D1099142
Laboratory TypePhysician Office
Certificate Effective DateJanuary 7, 2024
Certificate Expiration DateJuly 31, 2026
Laboratory DirectorDr. William J. Wickwire
Laboratory Phone(310) 798-1515
Laboratory LocationWilliam J Wickwire, MD Inc3831 Hughes Ave Ste, 504B, Culver City, CA 90232
CLIA data matches this NPI record on: 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 20

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

NAT-PHARM INC
Pharmacy (Community/Retail Pharmacy)
520 N PROSPECT AVE, STE 110
REDONDO BEACH, CA 90277
Los Angeles County (310) 379-9885
BRENDA SHEN M.D.
Family Medicine
520 N PROSPECT AVE, SUITE 103
REDONDO BEACH, CA 90277
Los Angeles County (310) 376-8816
DENISE DE GARCEAU
Physical Therapist (Orthopedic)
520 N PROSPECT AVE, SUITE 100
REDONDO BEACH, CA 90277
Los Angeles County (310) 376-9222
CONNIE TENG MD
Internal Medicine (Rheumatology)
520 N PROSPECT AVE
REDONDO BEACH, CA 90277
Los Angeles County (310) 318-9992
MADELINE CHANG
Occupational Therapist
520 N PROSPECT AVE, SUITE 100
REDONDO BEACH, CA 90277
Los Angeles County (310) 376-9222
MAUREEN M SWENSON M.D.
Family Medicine
520 N PROSPECT AVE, STE. 103
REDONDO BEACH, CA 90277
Los Angeles County (310) 376-8816
SAMINA KHANI MD
Internal Medicine
520 N PROSPECT AVE, STE 103
REDONDO BEACH, CA 90277
Los Angeles County (310) 376-8816
MARGUERITE MARY MCCORMICK NP
Nurse Practitioner
520 N PROSPECT AVE, SUITE 300
REDONDO BEACH, CA 90277
Los Angeles County (310) 372-1156

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 William J Wickwire M D Inc A Professional Corporation's NPI number?

The NPI number for William J Wickwire M D Inc A Professional Corporation is 1326119165. It was assigned to this organization in the NPPES registry on November 13, 2006. The provider is doing business as Beach Cities Dematology Med Center.

Where is William J Wickwire M D Inc A Professional Corporation located?

William J Wickwire M D Inc A Professional Corporation is located at 520 N Prospect Ave Ste 302, Redondo Beach, CA 90277. The listed phone number is (310) 798-1515.

What is William J Wickwire M D Inc A Professional Corporation's specialty?

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

Does William J Wickwire M D Inc A Professional Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0694537) is associated with this NPI, valid through July 13, 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 William J Wickwire M D Inc A Professional Corporation was last updated on March 24, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.