DERMATOLOGY SURGICAL & MEDICAL GROUP
NPI 1962509109
Dermatology in Santa Cruz, CA

Active since September 20, 2006CLIA 05D0606845 · Certificate of Compliance
1661 SOQUEL DR, BUILDING E, SANTA CRUZ, CA 95065(831) 476-2444(831) 476-3271 Get Directions Write a Review

NPPES record last updated: June 26, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dermatology Surgical & Medical Group NPPES

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

DERMATOLOGY SURGICAL & MEDICAL GROUP (NPI 1962509109) is a healthcare organization registered as a dermatology in Santa Cruz, California and active in the NPI registry since September 2006. The organization holds a CLIA Certificate of Compliance certificate valid through October 27, 2026 and lists Diana Niles, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1962509109
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY SURGICAL & MEDICAL GROUP
Location Address1661 SOQUEL DR, BUILDING ESanta Cruz, CA 95065
Mailing Address1661 Soquel Dr, Building ESanta Cruz, CA 95065-1709 · (831) 476-2444 · Fax (831) 476-3271
Fax(831) 476-3271
Organization SubpartNo
Authorized OfficialDiana NilesOffice Manager · (831) 476-2444
Enumeration DateSeptember 20, 2006
Last NPPES UpdateJune 26, 2018
NPI 1962509109 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.

1661 SOQUEL DR, Santa Cruz, CA 95065

Other Identifiers 1

MedicaidGR0053090CA

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 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
05D0606845
Facility Type
Physician Office
Certificate Effective Date
October 28, 2024
Certificate Expiration Date
October 27, 2026
Laboratory Director
MORGAN L. MAGID
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Dermatology Surgical & Medical Group after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BUILDING G
SANTA CRUZ, CA 95065
Psychiatry & Neurology (Neurology)
1661 SOQUEL DR, #D
SANTA CRUZ, CA 95065
Psychiatry & Neurology (Neurology)
1661 SOQUEL DR, SUITE F
SANTA CRUZ, CA 95065
Psychiatry & Neurology (Neurology)
1661 SOQUEL DR, #D
SANTA CRUZ, CA 95065
Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BUILDING G
SANTA CRUZ, CA 95065
Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BUILDING G
SANTA CRUZ, CA 95065
Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BLDG G
SANTA CRUZ, CA 95065
Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BLDG G
SANTA CRUZ, CA 95065
Obstetrics & Gynecology
1661 SOQUEL DR, BUILDING A
SANTA CRUZ, CA 95065
Nurse Practitioner (Adult Health)
1661 SOQUEL DR, BUILDING C
SANTA CRUZ, CA 95065
Radiology (Diagnostic Radiology)
1661 SOQUEL DR, BLDG G
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR, SUITE, D
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR, SUITE D
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR
SANTA CRUZ, CA 95065
Hospitalist
1661 SOQUEL DR
SANTA CRUZ, CA 95065
Obstetrics & Gynecology
1661 SOQUEL DR, SUITE A
SANTA CRUZ, CA 95065
Obstetrics & Gynecology
1661 SOQUEL DR, SUITE A
SANTA CRUZ, CA 95065
Obstetrics & Gynecology
1661 SOQUEL DR, SUITE A
SANTA CRUZ, CA 95065

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962509109, enumerated as an "organization" on September 20, 2006.

The provider is located at 1661 SOQUEL DR BUILDING E SANTA CRUZ, CA 95065 and the phone number is (831) 476-2444.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.