SOCAL SKIN AND SURGERY
NPI 1710687157
Dermatology in Los Angeles, CA
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
Specialties & Licenses
Other Names 1
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Socal Skin And Surgery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Socal Skin And Surgery, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Los Angeles, CA 90066
Los Angeles, CA 90066
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 05D2305428
Socal Skin And Surgery · Los Angeles, CAFrequently 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.
Is Socal Skin And Surgery enrolled in Medicare?
Yes. Socal Skin And Surgery is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Socal Skin And Surgery?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Dermatology, reassign their Medicare billing to Socal Skin And Surgery. 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, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
# Socal Skin And Surgery · NPI 1710687157
Dermatology organization in Los Angeles, California. Organization record, active in the CMS NPPES registry since March 6, 2023.
## Identity
- **NPI:** 1710687157 (Entity type: Organization)
- **Enumerated:** March 6, 2023
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Jenny Wang, DERMATOLOGIST
## Practice location
- **Address:** 12555 W JEFFERSON BLVD STE 202, Los Angeles, CA 90066-7047
- **Phone:** (424) 543-0066
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 4, 2023
- **Other identifiers:** Medicaid 1679036719 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1710687157) · Data from the CMS NPPES public registry.