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COASTAL MEDICAL AND COSMETIC DERMATOLOGY INC
NPI 1346488004
Dermatology in La Jolla, CA

Active since February 03, 2009CLIA 05D1094617 · Certificate of Compliance
9850 GENESEE AVE STE 500, LA JOLLA, CA 92037(858) 657-0267 Get Directions Write a Review

NPPES record last updated: December 17, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Coastal Medical And Cosmetic Dermatology Inc NPPES

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

COASTAL MEDICAL AND COSMETIC DERMATOLOGY INC (NPI 1346488004) is a healthcare organization registered as a dermatology in La Jolla, California and active in the NPI registry since February 2009. The organization holds a CLIA Certificate of Compliance certificate valid through October 21, 2027 and lists Darrell Wayne Gonzales, Owner, President, Cfo, as its authorized official.

NPPES Registry Identity

NPI1346488004
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCOASTAL MEDICAL AND COSMETIC DERMATOLOGY INC
Location Address9850 GENESEE AVE STE 500La Jolla, CA 92037-1213
Mailing Address9850 Genesee Ave Ste 850La Jolla, CA 92037-1213 · (858) 657-0267
Phone(858) 657-0267
Organization SubpartNo
Authorized OfficialDarrell Wayne GonzalesOwner, President, Cfo · (858) 657-0267
Enumeration DateFebruary 3, 2009
Last NPPES UpdateDecember 17, 2015
✔ NPI 1346488004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · A88738
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.
9850 GENESEE AVE STE 500, La Jolla, CA 92037
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Other Identifiers 2

Other1417960188Individual Npi
Medicare PINBK114

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)

Coastal Medical And Cosmetic Dermatology Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Coastal Medical And Cosmetic Dermatology Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Alyssa Nash-Goelitz, M.D.
Dermatology
NPI 1518064641
9850 GENESEE AVENUE SUITE 850
La Jolla, CA 92037
(858) 657-0267
✔ PECOS✔ Accepts MedicareSame address
Darrell Gonzales, M.D.
Dermatology
NPI 1417960188
9850 GENESEE AVE SUITE 500
La Jolla, CA 92037
(858) 657-0267
✔ PECOS✔ Accepts Medicare0.2 mi
Timothy Chang, MD
Dermatology
NPI 1962766337
9850 GENESEE AVE STE 850
La Jolla, CA 92037
(858) 657-0267
✔ PECOS✔ Accepts Medicare0.2 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 05D1094617

Coastal Medical & Cosmetic Dermatology · La Jolla, CA
Active · expires Oct 21, 2027
CLIA Number05D1094617
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2025
Certificate Expiration DateOctober 21, 2027
Laboratory DirectorDarrell W. Gonzales MD
Laboratory Phone(858) 657-0267
Laboratory LocationCoastal Medical & Cosmetic Dermatology9850 Genesee Ave, Ste 850, La Jolla, CA 92037
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.

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 Coastal Medical And Cosmetic Dermatology Inc's NPI number?

The NPI number for Coastal Medical And Cosmetic Dermatology Inc is 1346488004. It was assigned to this organization in the NPPES registry on February 3, 2009.

Where is Coastal Medical And Cosmetic Dermatology Inc located?

Coastal Medical And Cosmetic Dermatology Inc is located at 9850 Genesee Ave Ste 500, La Jolla, CA 92037. The listed phone number is (858) 657-0267.

What is Coastal Medical And Cosmetic Dermatology Inc's specialty?

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

Is Coastal Medical And Cosmetic Dermatology Inc enrolled in Medicare?

Yes. Coastal Medical And Cosmetic Dermatology Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Coastal Medical And Cosmetic Dermatology Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Coastal Medical And Cosmetic Dermatology 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 and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Coastal Medical And Cosmetic Dermatology Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D1094617) is associated with this NPI, valid through October 21, 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 Coastal Medical And Cosmetic Dermatology Inc was last updated on December 17, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.