EAST COUNTY DERMATOLOGY MEDICAL GROUP INC
NPI 1346254000
Dermatology in El Cajon, CA

Active since July 28, 2006CLIA 05D0566339 · Certificate of Compliance
1679 E MAIN ST STE 208, EL CAJON, CA 92021(619) 442-4468(619) 442-1510 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About East County Dermatology Medical Group Inc NPPES

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

EAST COUNTY DERMATOLOGY MEDICAL GROUP INC (NPI 1346254000) is a healthcare organization registered as a dermatology in El Cajon, California and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through November 30, 2026 and lists Doyle D. Hansen, President, as its authorized official.

NPPES Registry Identity

NPI1346254000
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEAST COUNTY DERMATOLOGY MEDICAL GROUP INC
Location Address1679 E MAIN ST STE 208El Cajon, CA 92021-5213
Mailing Address1679 E Main St Ste 208El Cajon, CA 92021-5213 · (619) 442-4468 · Fax (619) 442-1510
Fax(619) 442-1510
Organization SubpartNo
Authorized OfficialDoyle D. HansenPresident · (619) 442-4468
Enumeration DateJuly 28, 2006
Last NPPES UpdateSeptember 1, 2026
NPPES CertifiedSeptember 1, 2026
✔ NPI 1346254000 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · G25265
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.
1679 E MAIN ST STE 208, El Cajon, CA 92021

Other Identifiers 2

MedicaidGR0017820CA
MedicaidGR0017821CA

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)

East County Dermatology Medical Group Inc 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 East County Dermatology Medical Group Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Dermatology
NPI 1790868735
1679 E MAIN ST
El Cajon, CA 92021
(619) 442-9441
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1366854960
NAVAL MEDICAL CTR 34800 BOB WILSON DR.
San Diego, CA 92134
(619) 532-6400
✔ PECOS✔ Accepts Medicare15 mi

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

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 05D0566339

East County Dermatology Medical Group · El Cajon, CA
Active · expires Nov 30, 2026
CLIA Number05D0566339
Laboratory TypePhysician Office
Certificate Effective DateSeptember 27, 2024
Certificate Expiration DateNovember 30, 2026
Laboratory DirectorDoyle D. Hansen
Laboratory Phone(619) 442-9628
Laboratory LocationEast County Dermatology Medical Group1679 E Main St, Ste 208, El Cajon, CA 92021
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.

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 East County Dermatology Medical Group Inc's NPI number?

The NPI number for East County Dermatology Medical Group Inc is 1346254000. It was assigned to this organization in the NPPES registry on July 28, 2006.

Where is East County Dermatology Medical Group Inc located?

East County Dermatology Medical Group Inc is located at 1679 E Main St Ste 208, El Cajon, CA 92021. The listed phone number is (619) 442-4468.

What is East County Dermatology Medical Group Inc's specialty?

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

Is East County Dermatology Medical Group Inc enrolled in Medicare?

Yes. East County Dermatology Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through East County Dermatology Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to East County Dermatology Medical Group Inc. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does East County Dermatology Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0566339) is associated with this NPI, valid through November 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 East County Dermatology Medical Group Inc was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.