BRENTWOOD DERMATOLOGY MEDICAL GROUP
NPI 1427089911
Dermatology in Los Angeles, CA
NPI Status: Active since July 05, 2006
Contact Information
11980 SAN VICENTE BLVD
SUITE # 120
LOS ANGELES, CA
ZIP 90049
Phone: (310) 826-2051
Fax: (310) 979-0185
- Organization
- Dermatology
- CLIA Number: 05D0997745
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-30-2025
About BRENTWOOD DERMATOLOGY MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Brentwood Dermatology Medical Group, a provider established in Los Angeles, California operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1427089911 assigned on July 2006. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Brentwood Dermatology Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Jack H Silvers M.d. (President)
- NPI
- 1427089911
- Provider Name
- BRENTWOOD DERMATOLOGY MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 11980 SAN VICENTE BLVD SUITE # 120 LOS ANGELES, CA 90049
- Location Phone
- (310) 826-2051
- Location Fax
- (310) 979-0185
- Mailing Address
- 11980 SAN VICENTE BLVD. SUITE # 120 LOS ANGELES, CA 90049
- Mailing Phone
- (310) 826-2051
- Mailing Fax
- (310) 979-0185
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-05-2006
- Last Update Date
- 08-22-2020
- Code Navigator
A dermatologist like Brentwood Dermatology Medical Group is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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
- 05D0997745
- Facility Type
- Physician Office
- Certificate Effective Date
- September 05, 2022
- Certificate Expiration Date
- June 30, 2025
- Laboratory Director
- JACK H. SILVERS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Brentwood Dermatology 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.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 0 | 8 | 9 | 9 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 0 | 8 | 18 | 9 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 0 + 8 + 1 + 8 + 9 + 2 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1427089911 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1033109335 | DR. HOPE W LEVIN MD Individual | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 11980 SAN VICENTE BLVD SUITE 809 LOS ANGELES, CA 90049 (310) 494-0108 |
| 1235172727 | DR. DAVID ETHAN SONES M.D. Individual | Psychiatry & Neurology (Psychiatry) | 11980 SAN VICENTE BLVD SUITE 701 LOS ANGELES, CA 90049 (310) 207-2006 |
| 1649214784 | DR. JACK SILVERS M.D Individual | Specialist | 11980 SAN VICENTE BLVD SUITE 120 LOS ANGELES, CA 90049 (310) 826-2051 |
| 1679508477 | DR. WILLIAM D HARRISON DDS Individual | Dentist | 11980 SAN VICENTE BLVD #918 LOS ANGELES, CA 90049 (310) 826-6535 |
| 1265457436 | DENISE SAMANTHA GARVEY MD Individual | Internal Medicine | 11980 SAN VICENTE BLVD 102 LOS ANGELES, CA 90049 (301) 208-7777 |
| 1003827551 | DR. DIANA MARCELA MEDINA DDS Individual | Dentist (Oral and Maxillofacial Surgery) | 11980 SAN VICENTE BLVD SUITE 505 LOS ANGELES, CA 90049 (310) 820-6691 |
| 1225145568 | DONALD A SALEM DDS Individual | Dentist (Orthodontics and Dentofacial Orthopedics) | 11980 SAN VICENTE BLVD SUITE 814 LOS ANGELES, CA 90049 (310) 820-4986 |
| 1295844058 | DR. DIANE CHIE TARICA DDS Individual | Dentist (Prosthodontics) | 11980 SAN VICENTE BLVD SUITE 906 LOS ANGELES, CA 90049 (310) 207-5700 |
| 1417059965 | DR. REGINA PETTERSON PSY.D. Individual | Psychologist | 11980 SAN VICENTE BLVD SUITE 701 LOS ANGELES, CA 90049 (310) 462-3134 |
| 1649367350 | EVA L HOGAN MUDR DDS MS Individual | Dentist (Periodontics) | 11980 SAN VICENTE BLVD 503 LOS ANGELES, CA 90049 (310) 966-9444 |
| 1689754848 | SUSAN N FUKUSHIMA MD INC Organization | Psychiatry & Neurology (Psychiatry) | 11980 SAN VICENTE BLVD SUITE 701 LOS ANGELES, CA 90049 (310) 826-9550 |
| 1225191455 | DR. GARY H SALENGER DDS Individual | Dentist | 11980 SAN VICENTE BLVD SUITE 600 LOS ANGELES, CA 90049 (310) 826-8321 |
| 1073659355 | DR. VICTOR PINESCHI DDS, MS,APC Individual | Dentist (Periodontics) | 11980 SAN VICENTE BLVD #811 LOS ANGELES, CA 90049 (310) 826-8911 |
| 1669519369 | KEVIN BARRETT D.D.S. Individual | Dentist (General Practice) | 11980 SAN VICENTE BLVD SUITE 802 LOS ANGELES, CA 90049 (310) 820-4952 |
| 1841337581 | DR. PETER K MOY DMD. Individual | Dentist (Oral and Maxillofacial Surgery) | 11980 SAN VICENTE BLVD SUITE 503 AND 505 LOS ANGELES, CA 90049 (310) 820-6691 |
| 1902945942 | DR. VAN DYKE DEGOLIA M.D. Individual | Psychiatry & Neurology (Child & Adolescent Psychiatry) | 11980 SAN VICENTE BLVD SUITE 902 LOS ANGELES, CA 90049 (310) 826-1915 |
| 1609918275 | DR. THOMAS FREDEERICK TROTT MD Individual | Psychiatry & Neurology (Psychiatry) | 11980 SAN VICENTE BLVD SUITE 607 LOS ANGELES, CA 90049 (310) 208-6991 |
| 1659406361 | DR. MAUREEN FULCHIERO GORDON M.D. Individual | Psychiatry & Neurology (Psychiatry) | 11980 SAN VICENTE BLVD #704 LOS ANGELES, CA 90049 (310) 826-2664 |
| 1649303116 | DR. JOSHUA EMANUEL PRETSKY M.D. Individual | Psychiatry & Neurology (Psychiatry) | 11980 SAN VICENTE BLVD SUITE #910 LOS ANGELES, CA 90049 (310) 826-8633 |
| 1659497824 | DR. BEHROOZ A. TORKIAN MD Individual | Otolaryngology (Facial Plastic Surgery) | 11980 SAN VICENTE BLVD SUITE 715 LOS ANGELES, CA 90049 (310) 652-6673 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427089911, enumerated in the NPI registry as an "organization" on July 05, 2006
The provider is located at 11980 San Vicente Blvd Suite # 120 Los Angeles, Ca 90049 and the phone number is (310) 826-2051
This medical organization specializes in Dermatology with taxonomy code 207N00000X
The provider's CLIA number is 05D0997745 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued 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..
This NPI record was last updated on July 05, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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