GOLDEN STATE DERMATOLOGY, INC.
NPI 1407285240
in Walnut Creek, CA

NPI Status: Active since November 02, 2013

Contact Information

2255 YGNACIO VALLEY RD STE B1
WALNUT CREEK, CA
ZIP 94598
Phone: (925) 945-1127
Fax: (925) 945-0804

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
CLIA Number: 05D0691462
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 11-06-2026

About GOLDEN STATE DERMATOLOGY, INC.

This page provides the complete NPI Profile along with additional information for Golden State Dermatology, Inc., a provider established in Walnut Creek, California operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1407285240 assigned on November 2013. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Golden State Dermatology, Inc. operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Edward V Becker M.d. (President)

NPI: 1407285240
Provider Name: GOLDEN STATE DERMATOLOGY, INC.
Entity Type: Organization
Location Address: 2255 YGNACIO VALLEY RD STE B1 WALNUT CREEK, CA 94598
Location Phone: (925) 945-1127
Location Fax: (925) 945-0804
Mailing Address: 2255 YGNACIO VALLEY RD. SUITE B-1 WALNUT CREEK, CA 94598
Mailing Phone: (925) 945-7005
Mailing Fax: (925) 945-0804
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 11-02-2013
Last Update Date: 07-20-2017
Code Navigator

A dermatologist like Golden State 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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

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. EDWARD V BECKER M.D.
Authorized Official Title: PRESIDENT
Authorized Official Phone: (925) 945-7005

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: 05D0691462
Facility Type: Physician Office
Certificate Effective Date: November 07, 2024
Certificate Expiration Date: November 06, 2026
Laboratory Director: JAY ZIMMERMAN
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Golden State Dermatology, Inc. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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	4	0	7	2	8	5	2	4	0
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	4	0	7	4	8	10	2	8
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 0 + 7 + 4 + 8 + 1 + 0 + 2 + 8 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
									0

The NPI number 1407285240 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.