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

NPI Status: Active since February 03, 2009

Contact Information

9850 GENESEE AVE STE 500
LA JOLLA, CA
ZIP 92037
Phone: (858) 657-0267

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  • Organization
  • Dermatology
  • CLIA Number: 05D1094617
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-30-2025

About COASTAL MEDICAL AND COSMETIC DERMATOLOGY INC

This page provides the complete NPI Profile along with additional information for Coastal Medical And Cosmetic Dermatology Inc, a provider established in La Jolla, California operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1346488004 assigned on February 2009. The practitioner's primary taxonomy code is 207N00000X with license number A88738 (CA). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Darrell Wayne Gonzales M.d. (Owner, President, Cfo)

NPI
1346488004
Provider Name
COASTAL MEDICAL AND COSMETIC DERMATOLOGY INC
Entity Type
Organization
Location Address
9850 GENESEE AVE STE 500 LA JOLLA, CA 92037
Location Phone
(858) 657-0267
Mailing Address
9850 GENESEE AVE STE 850 LA JOLLA, CA 92037
Mailing Phone
(858) 657-0267
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-03-2009
Last Update Date
12-17-2015
Code Navigator

A dermatologist like Coastal Medical And Cosmetic Dermatology Inc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
License No.
A88738
License State
CA
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. DARRELL WAYNE GONZALES M.D.

Authorized Official Title
OWNER, PRESIDENT, CFO
Authorized Official Phone
(858) 657-0267

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1417960188OTHER (01)INDIVIDUAL NPI
BK114MEDICARE PIN (08) 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1094617
Facility Type
Physician Office
Certificate Effective Date
October 22, 2021
Certificate Expiration Date
September 30, 2025
Laboratory Director
DARRELL W. GONZALES MD
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Coastal Medical And Cosmetic Dermatology Inc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1346488004, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
4
Doubled → 8
Pos 4
6
Unchanged
Pos 5
4
Doubled → 8
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
0
Unchanged
Pos 9
0
Doubled → 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 8 → 16 → 7 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 8 + 6 + 8 + 8 + 1 + 6 + 0 + 0 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1346488004.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Plastic Surgery
9850 GENESEE AVE STE 500
LA JOLLA, CA 92037
Plastic Surgery
9850 GENESEE AVE STE 500
LA JOLLA, CA 92037

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1346488004, enumerated as an "organization" on February 03, 2009.

The provider is located at 9850 GENESEE AVE STE 500 LA JOLLA, CA 92037 and the phone number is (858) 657-0267.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.