SOUTHERN CALIFORNIA DERMATOLOGY, INC
NPI 1386629905
Dermatology in Santa Ana, CA
NPI Status: Active since December 07, 2005
Contact Information
1125 E 17TH ST
W-248
SANTA ANA, CA
ZIP 92701
Phone: (714) 547-5151
Fax: (714) 541-2016
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 05D0580819
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-01-2025
About SOUTHERN CALIFORNIA DERMATOLOGY, INC
This page provides the complete NPI Profile along with additional information for Southern California Dermatology, Inc, a provider established in Santa Ana, California operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1386629905 assigned on December 2005. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Southern California Dermatology, Inc. The authorized official of this NPI record is Jonathan A Baron Md (Owner)
- NPI
- 1386629905
- Provider Legal Name
- SOUTHERN CALIFORNIA DERMATOLOGY, INC
- Other Organization Name
- SOUTHERN CALIFORNIA DERMATOLOGY, INC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1125 E 17TH ST W-248 SANTA ANA, CA 92701
- Location Phone
- (714) 547-5151
- Location Fax
- (714) 541-2016
- Mailing Address
- 1125 E 17TH ST W-248 SANTA ANA, CA 92701
- Mailing Phone
- (714) 547-5151
- Mailing Fax
- (714) 541-2016
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-07-2005
- Last Update Date
- 01-29-2020
- Code Navigator
A dermatologist like Southern California 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.
Location Map
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
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332900000X | Suppliers | Non-Pharmacy Dispensing Site |
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:
- Moda Health Affinity Bronze 7750 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Pioneer Alaska Standard Bronze - PPO
- Moda Pioneer Alaska Standard Gold - PPO
- Moda Pioneer Alaska Standard Silver - PPO
- Moda Pioneer Bronze 6500 - PPO
- Moda Pioneer Bronze HDHP 5500 - PPO
- Moda Pioneer Gold 1500 - PPO
- Moda Pioneer Silver 4500 - PPO
- Essential Bronze 6500 - POS
- Essential Gold 1500 - POS
- Freedom Silver 4000 - POS
- Savings Bronze 7700 - POS
- Standard Bronze 7500 - POS
- Standard Gold 1500 - POS
- Standard Silver 5000 - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 05D0580819
- Facility Type
- Physician Office
- Certificate Effective Date
- August 02, 2023
- Certificate Expiration Date
- August 01, 2025
- Laboratory Director
- DR. JONATHAN A. BARON
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Southern California 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 Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 8 | 6 | 6 | 2 | 9 | 9 | 0 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 16 | 6 | 12 | 2 | 18 | 9 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 6 + 6 + 1 + 2 + 2 + 1 + 8 + 9 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1386629905 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
DR. ROGER HSIO-HSION WANG M.D.
Family Medicine
(Adult Medicine)
1125 E 17TH ST
SUITE W239
SANTA ANA, CA
ZIP 92701
JONATHAN ALEC BARON MD
Dermatology
1125 E 17TH ST
STE W248
SANTA ANA, CA
ZIP 92701
RANDI IRENE PASSERO PA C
Physician Assistant
1125 E 17TH ST
W248
SANTA ANA, CA
ZIP 92701
MR. JOSE L. VALDEZ M.D.
Family Medicine
1125 E 17TH ST
STE E-224
SANTA ANA, CA
ZIP 92701
WILLIAM LEROY BARTLETT M.D.
Pediatrics
1125 E 17TH ST
W-131
SANTA ANA, CA
ZIP 92701
MARGARET MARY DESA M.D.
Specialist
1125 E 17TH ST
SUITE N-351
SANTA ANA, CA
ZIP 92701
DR. YOON HEE CHOE DDS
Dentist
1125 E 17TH ST
#N 257
SANTA ANA, CA
ZIP 92701
DR. DON L SMITH M.D.
Family Medicine
(Adult Medicine)
1125 E 17TH ST
SUITE N453
SANTA ANA, CA
ZIP 92701
DR. HUNG I CHEN MD
Pediatrics
1125 E 17TH ST
N354
SANTA ANA, CA
ZIP 92701
MAHMOOD MOSTOUFI MD
Pediatrics
1125 E 17TH ST
STE E 110
SANTA ANA, CA
ZIP 92701
BEHZAD RADPARVAR LAC
Acupuncturist
1125 E 17TH ST
N560
SANTA ANA, CA
ZIP 92701
DR. MICHAEL J EINBUND MD
Orthopaedic Surgery
1125 E 17TH ST
#E218
SANTA ANA, CA
ZIP 92701
DR. JACOB RABINOVICH MD
Orthopaedic Surgery
1125 E 17TH ST
#E218
SANTA ANA, CA
ZIP 92701
DR. JON H. KENDALL OD
Optometrist
1125 E 17TH ST
N-455
SANTA ANA, CA
ZIP 92701
PACIFIC FOOT & ANKLE SPECIALISTS, INC.
Prosthetic/Orthotic Supplier
1125 E 17TH ST
SUITE E-107
SANTA ANA, CA
ZIP 92701
ADVANCED CARE
Specialist
1125 E 17TH ST
SUITE N560
SANTA ANA, CA
ZIP 92701
DARA SAGHAFI MD, DC, INC
Internal Medicine
1125 E 17TH ST
W-117
SANTA ANA, CA
ZIP 92701
PACIFIC FOOT & ANKLE SPECIALISTS
Podiatrist
(Foot & Ankle Surgery)
1125 E 17TH ST
SUITE E107
SANTA ANA, CA
ZIP 92701
DR. JAMSHID TAMIRY M.D.
Internal Medicine
1125 E 17TH ST
SANTA ANA, CA
ZIP 92701
AMIR AZIZI L.AC
Acupuncturist
1125 E 17TH ST
SUITE W-117
SANTA ANA, CA
ZIP 92701
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386629905, enumerated as an "organization" on December 07, 2005.
The provider is located at 1125 E 17TH ST W-248 SANTA ANA, CA 92701 and the phone number is (714) 547-5151.
Dermatology with taxonomy code 207N00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc. and Primewell Health. Please consult your insurance carrier or call the provider to verify.
