CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM – NPI #1356408934
Dermatology

A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents.

CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM is a dermatologist located in SAN DIEGO, CA. NPPES has assigned the NPI number 1356408934 to CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM on January 02, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is CHILDREN'S ASSOCIATED MEDICAL GROUP. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207NP0225X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in Pediatric Dermatology

The NPI profile was previously updated about 18 years ago on Apr 22, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM below.

NPI Profile for
CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM

NPI Number
1356408934
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM
Former Legal Business Name: CHILDREN'S ASSOCIATED MEDICAL GROUP
Primary location
8010 FROST ST
SUITE 602
SAN DIEGO, CA 92123-2778
Phone: (858) 966-6795 Fax:
Mailing address
3860 CALLE FORTUNADA
SUITE 210
SAN DIEGO, CA 92123-4800
Phone: (858) 309-6303 Fax: (858) 309-6301
Organization Subpart
Yes - CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM is subpart of another organization.
Authorized Official
HERBERT KIMMONS
PRESIDENT
Phone: (858) 966-8567
Updated
Identifiers

Identifiers for CHILDREN'S SPECIALIST OF SAN DIEGO - DIV OF DERM

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCAGR006886A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207NP0225X
- Dermatology / Pediatric Dermatology (Primary)
208000000X
- Pediatrics
207N00000X
- Dermatology

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.