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VALLEY DERMATOLOGIC MEDICAL GROUP, INC
NPI 1699770719
Dermatology in Tarzana, CA

Active since June 15, 2005CLIA 05D0559333 · Certificate of Compliance
18364 CLARK ST, TARZANA, CA 91356(881) 345-7122(818) 345-7448 Get Directions Write a Review

NPPES record last updated: April 8, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Valley Dermatologic Medical Group, Inc NPPES

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

VALLEY DERMATOLOGIC MEDICAL GROUP, INC (NPI 1699770719) is a healthcare organization registered as a dermatology in Tarzana, California and active in the NPI registry since June 2005. The organization holds a CLIA Certificate of Compliance certificate valid through April 3, 2027 and lists Donald R Seidman, President, as its authorized official.

NPPES Registry Identity

NPI1699770719
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameVALLEY DERMATOLOGIC MEDICAL GROUP, INC
Location Address18364 CLARK STTarzana, CA 91356-3502
Mailing Address18364 Clark StTarzana, CA 91356-3502 · (881) 345-7122 · Fax (818) 345-7448
Phone(881) 345-7122
Fax(818) 345-7448
Organization SubpartNo
Authorized OfficialDonald R SeidmanPresident · (818) 345-7122
Enumeration DateJune 15, 2005
Last NPPES UpdateApril 8, 2008
✔ NPI 1699770719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in CA · A19349
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.
18364 CLARK ST, Tarzana, CA 91356
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Other Identifiers 1

Medicare ID-Type UnspecifiedW781CA · Medicare Provider Group #

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Valley Dermatologic Medical Group, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Valley Dermatologic Medical Group, Inc, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Ada Winkielman, MD
Dermatology
NPI 1992798870
18364 CLARK ST
Tarzana, CA 91356
(818) 345-7122
✔ PECOS✔ Accepts MedicareSame address
Daniel Gross, MD
Dermatology
NPI 1396740056
18364 CLARK ST
Tarzana, CA 91356
(818) 345-7122
✔ PECOS✔ Accepts MedicareSame address
Charles Linden, MD
Dermatology
NPI 1508861634
18364 CLARK ST
Tarzana, CA 91356
(818) 345-7122
✔ PECOS✔ Accepts MedicareSame address
Clayton Hinshaw, MD
Dermatology
NPI 1326043456
2925 SYCAMORE DR STE 204
Simi Valley, CA 93065
(805) 409-9199
✔ PECOS✔ Accepts Medicare15 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

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 of Compliance 05D0559333

Valley Dermatologic Medical Group · Tarzana, CA
Active · expires Apr 3, 2027
CLIA Number05D0559333
Laboratory TypePhysician Office
Certificate Effective DateApril 4, 2025
Certificate Expiration DateApril 3, 2027
Laboratory DirectorCharles E. Linden MD
Laboratory Phone(818) 345-7122
Laboratory LocationValley Dermatologic Medical Group18364 Clark St, Tarzana, CA 91356
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Valley Dermatologic Medical Group, Inc's NPI number?

The NPI number for Valley Dermatologic Medical Group, Inc is 1699770719. It was assigned to this organization in the NPPES registry on June 15, 2005.

Where is Valley Dermatologic Medical Group, Inc located?

Valley Dermatologic Medical Group, Inc is located at 18364 Clark St, Tarzana, CA 91356. The listed phone number is (881) 345-7122.

What is Valley Dermatologic Medical Group, Inc's specialty?

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

Is Valley Dermatologic Medical Group, Inc enrolled in Medicare?

Yes. Valley Dermatologic Medical Group, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Valley Dermatologic Medical Group, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Dermatology, reassign their Medicare billing to Valley Dermatologic Medical Group, 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Valley Dermatologic Medical Group, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D0559333) is associated with this NPI, valid through April 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Valley Dermatologic Medical Group, Inc was last updated on April 8, 2008. 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.