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CENTER FOR DERMATOLOGY COSMETIC AND LASER SURGERY
NPI 1467640284
Specialist in Milpitas, CA

Active since October 05, 2007CLIA Certified · 2 labs
1158 JACKLIN RD, MILPITAS, CA 95035(408) 957-7676(408) 942-1342 Get Directions Write a Review

NPPES record last updated: October 5, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Center For Dermatology Cosmetic And Laser Surgery NPPES

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

CENTER FOR DERMATOLOGY COSMETIC AND LASER SURGERY (NPI 1467640284) is a healthcare organization registered as a specialist in Milpitas, California and active in the NPI registry since October 2007. The organization holds 2 active CLIA laboratory certificates and lists Sunil S. Dhawan, Secretary Of The Corporation, as its authorized official.

NPPES Registry Identity

NPI1467640284
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameEAST BAY DERMATOLOGY MEDICAL GROUP INC.
Location Address1158 JACKLIN RDMilpitas, CA 95035-3700
Mailing Address2557 Mowry Ave Ste 34Fremont, CA 94538-1614 · (510) 797-4111 · Fax (510) 797-3320
Phone(408) 957-7676
Fax(408) 942-1342
Organization SubpartNo
Authorized OfficialSunil S. DhawanSecretary Of The Corporation · (408) 957-7676
Enumeration DateOctober 5, 2007
✔ NPI 1467640284 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in CA · G53340
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1158 JACKLIN RD, Milpitas, CA 95035
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Other Names 1

Doing Business AsCenter For Dermatology Cosmetic And Laser Surgery

Other Identifiers 2

Medicare UPINE36247CA
Medicare PINZZZ22782ZCA

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

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 05D2301604

Center For Dermatology Clinical Research · Fremont, CA
Active · expires Mar 27, 2028
CLIA Number05D2301604
Laboratory TypePhysician Office
Certificate Effective DateMarch 28, 2026
Certificate Expiration DateMarch 27, 2028
Laboratory DirectorSunil S. Dhawan
Laboratory Phone(510) 797-0140
Laboratory LocationCenter For Dermatology Clinical Research2557 Mowry Ave Ste 34, Fremont, CA 94538
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0866311

East Bay Dermatology Medical Group Inc · Milpitas, CA
Active · expires Jan 18, 2028
CLIA Number05D0866311
Laboratory TypePhysician Office
Certificate Effective DateJanuary 19, 2026
Certificate Expiration DateJanuary 18, 2028
Laboratory DirectorShurong S. Chang
Laboratory Phone(408) 957-7676
Laboratory LocationEast Bay Dermatology Medical Group Inc995 Montague Expressway Ste 111, Milpitas, CA 95035
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 East Bay Dermatology Medical Group Inc.'s NPI number?

The NPI number for East Bay Dermatology Medical Group Inc. is 1467640284. It was assigned to this organization in the NPPES registry on October 5, 2007. The provider is doing business as Center For Dermatology Cosmetic And Laser Surgery.

Where is East Bay Dermatology Medical Group Inc. located?

East Bay Dermatology Medical Group Inc. is located at 1158 Jacklin Rd, Milpitas, CA 95035. The listed phone number is (408) 957-7676.

What is East Bay Dermatology Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does East Bay Dermatology Medical Group Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for East Bay Dermatology Medical Group Inc. was last updated on October 5, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.