1. Home
  2. Directory
  3. California
  4. Los Angeles
  5. Dermatology
  6. NPI Profile

SOCAL SKIN AND SURGERY
NPI 1710687157
Dermatology in Los Angeles, CA

Active since March 06, 2023CLIA 05D2305428 · Certificate of Compliance
12555 W JEFFERSON BLVD STE 202, LOS ANGELES, CA 90066(424) 543-0066 Get Directions Write a Review

NPPES record last updated: July 4, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Jul 4, 2023, Mar 6, 2023 (2 updates tracked since 2023).

About Socal Skin And Surgery NPPES

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

SOCAL SKIN AND SURGERY (NPI 1710687157) is a healthcare organization registered as a dermatology in Los Angeles, California and active in the NPI registry since March 2023. The organization holds a CLIA Certificate of Compliance certificate valid through January 14, 2027 and lists Jenny Zhuoyue Wang, Dermatologist, as its authorized official.

NPPES Registry Identity

NPI1710687157
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOCAL SKIN AND SURGERY
Location Address12555 W JEFFERSON BLVD STE 202Los Angeles, CA 90066-7047
Mailing Address12555 W Jefferson Blvd Ste 202Los Angeles, CA 90066-7047 · (424) 543-0066
Phone(424) 543-0066
Organization SubpartNo
Authorized OfficialJenny Zhuoyue WangDermatologist · (240) 246-3164
Enumeration DateMarch 6, 2023
Last NPPES UpdateJuly 4, 20232 updates tracked since enumeration
NPPES CertifiedJuly 4, 2023
✔ NPI 1710687157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
12555 W JEFFERSON BLVD STE 202, Los Angeles, CA 90066
Open in Google Maps ↗

Other Names 1

Doing Business AsSocal Skin And Surgery

Other Identifiers 1

Medicaid1679036719CA

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

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 05D2305428

Socal Skin And Surgery · Los Angeles, CA
Active · expires Jan 14, 2027
CLIA Number05D2305428
Laboratory TypePhysician Office
Certificate Effective DateJanuary 15, 2025
Certificate Expiration DateJanuary 14, 2027
Laboratory DirectorJenny Z. Wang
Laboratory Phone(424) 543-0066
Laboratory LocationSocal Skin And Surgery12555 W Jefferson Blvd, Ste 202, Los Angeles, CA 90066
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.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JENNY ZHUOYUE WANG MD
Dermatology
12555 W JEFFERSON BLVD STE 202
LOS ANGELES, CA 90066
Los Angeles County (424) 543-0066
RAMYA GARLAPATI
Dermatology
12555 W JEFFERSON BLVD STE 202
LOS ANGELES, CA 90066
Los Angeles County (424) 541-1756
DR. ARDESHIR EDWARD NADIMI M.D.
Dermatology (MOHS-Micrographic Surgery)
12555 W JEFFERSON BLVD STE 202
LOS ANGELES, CA 90066
Los Angeles County (424) 541-1756

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 Socal Skin And Surgery's NPI number?

The NPI number for Socal Skin And Surgery is 1710687157. It was assigned to this organization in the NPPES registry on March 6, 2023.

Where is Socal Skin And Surgery located?

Socal Skin And Surgery is located at 12555 W Jefferson Blvd Ste 202, Los Angeles, CA 90066. The listed phone number is (424) 543-0066.

What is Socal Skin And Surgery's specialty?

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

Does Socal Skin And Surgery hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 05D2305428) is associated with this NPI, valid through January 14, 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 Socal Skin And Surgery was last updated on July 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.