SOUTHERN CALIFORNIA DERMATOLOGY, INC
NPI 1386629905
Dermatology in Santa Ana, CA

Q: What is Southern California Dermatology, Inc's NPI number?

The NPI number for Southern California Dermatology, Inc is 1386629905. It was assigned to this organization in the NPPES registry on December 7, 2005.

Q: What is Southern California Dermatology, Inc's specialty?

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

Active since December 07, 2005

1125 E 17TH ST, W-248, SANTA ANA, CA 92701(714) 547-5151(714) 541-2016 Get Directions Write a Review

NPPES record last updated: January 29, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Southern California Dermatology, Inc NPPES

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

SOUTHERN CALIFORNIA DERMATOLOGY, INC (NPI 1386629905) is a healthcare organization registered as a dermatology in Santa Ana, California and active in the NPI registry since December 2005. The organization lists Jonathan A Baron, Owner, as its authorized official.

NPPES Registry Identity

NPI1386629905

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameSOUTHERN CALIFORNIA DERMATOLOGY, INC

Location Address1125 E 17TH ST, W-248Santa Ana, CA 92701-2201

Mailing Address1125 E 17th St, W-248Santa Ana, CA 92701-2201 · (714) 547-5151 · Fax (714) 547-4027

Phone(714) 547-5151

Fax(714) 541-2016

Organization SubpartNo

Authorized OfficialJonathan A BaronOwner · (714) 547-5151

Enumeration DateDecember 7, 2005

Last NPPES UpdateJanuary 29, 2020

✔ NPI 1386629905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

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.

Also ListedNon-Pharmacy Dispensing SiteTaxonomy 332900000X

1125 E 17TH ST, Santa Ana, CA 92701

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Other Names 1

Doing Business AsSouthern California Dermatology, Inc

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern California Dermatology, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 7 clinicians reassign Medicare billing to Southern California Dermatology, Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Jennifer Soung, M.D.

Dermatology

NPI 1346408226

1125 E 17TH STREET SUITE W248
Santa Ana, CA 92701

(714) 547-5151

✔ PECOS✔ Accepts MedicareSame address

Trevor Muirhead, M.D.

Dermatology

NPI 1386819241

1125 E 17TH ST STE W248
Santa Ana, CA 92701

(714) 547-5151

✔ PECOS✔ Accepts MedicareSame address

Jonathan Baron, MD

Dermatology

NPI 1982686333

1125 E 17TH ST STE W248
Santa Ana, CA 92701

(714) 547-5151

✔ PECOS✔ Accepts Medicare0.1 mi

Derek Hsu, MD

Dermatology

NPI 1477944841

1125 E 17TH ST STE W248
Santa Ana, CA 92701

(714) 547-5151

✔ PECOS✔ Accepts Medicare0.1 mi

Jeffrey Joseph, M.D.

Ophthalmology

NPI 1134395205

5010 CAMPUS DR STE 100
Newport Beach, CA 92660

(949) 424-3524

✔ PECOS✔ Accepts Medicare6.5 mi

Lisa Xu, M.D.

Dermatology

NPI 1013118256

5010 CAMPUS DR STE 120
Newport Beach, CA 92660

(949) 773-4784

✔ PECOS✔ Accepts Medicare6.5 mi

Albert Antonyan, MD

Dermatology

NPI 1457770273

24520 HAWTHORNE BLVD STE 240
Torrance, CA 90505

(310) 300-6206

✔ PECOS✔ Accepts Medicare29 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 Southern California Dermatology, Inc's NPI number?

The NPI number for Southern California Dermatology, Inc is 1386629905. It was assigned to this organization in the NPPES registry on December 7, 2005.

Where is Southern California Dermatology, Inc located?

Southern California Dermatology, Inc is located at 1125 E 17th St W-248, Santa Ana, CA 92701. The listed phone number is (714) 547-5151.

What is Southern California Dermatology, Inc's specialty?

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

Is Southern California Dermatology, Inc enrolled in Medicare?

Yes. Southern California Dermatology, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern California Dermatology, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Southern California 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. The largest specialties are Dermatology (6) and Ophthalmology (1). Of these, 2 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southern California Dermatology, Inc accept?

Health plans from Moda Health Plan, Inc. list Southern California Dermatology, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southern California Dermatology, Inc was last updated on January 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.