California Dermatology Center
Dermatology, Procedural Dermatology in Diamond Bar, CA. Organization (NPI-2).
NPI number1407883770
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1407883770
- Entity type
- Organization (NPI-2)
- Legal business name
- California Dermatology Center
- Organization subpart
- No
- Enumeration date
- Jun 26, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207NS0135X | Dermatology, Procedural Dermatology | g44761 | CA | Yes |
| 207N00000X | Dermatology | g44761 | CA | |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | g44761 | CA | |
| 207ND0900X | Dermatology, Dermatopathology | g44761 | CA | |
| 207NI0002X | Dermatology, Clinical & Laboratory Dermatological Immunology | g44761 | CA | |
| 207NP0225X | Dermatology, Pediatric Dermatology | g44761 | CA |
Practice location
23525 Golden Springs DrDiamond Bar, CA 91765-2175
Phone 909-860-7600
Mailing address
602 N Roxbury DrBeverly Hills, CA 90210-3228
Phone 310-200-8705
Authorized official
Glenn Neil Ledesma
Owner
3103606661
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