Provider Demographics
NPI:1487707097
Name:WEST HILLS DERMATOLOGY GROUP A MEDICAL CORPORATION
Entity type:Organization
Organization Name:WEST HILLS DERMATOLOGY GROUP A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:MEHRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMPOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-592-6005
Mailing Address - Street 1:7230 MEDICAL CENTER DR STE 404
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-4016
Mailing Address - Country:US
Mailing Address - Phone:818-592-6005
Mailing Address - Fax:818-592-6088
Practice Address - Street 1:7230 MEDICAL CENTER DR STE 404
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-4016
Practice Address - Country:US
Practice Address - Phone:818-592-6005
Practice Address - Fax:818-592-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55703207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPA16949BMedicare ID - Type Unspecified
CAQ26881Medicare UPIN
CAW14930Medicare ID - Type Unspecified
CAG69027Medicare UPIN