Southern California Dermatology is an authorized DME supplier for medicare equipments and products.
Southern California Dermatology is a Procedural Dermatology in Dallas, Texas. This pharmacy is owned and operated by J Robert West, M.d., Inc. This organization is also known as sub part of J Robert West, M.d., Inc. It is located at 12700 Park Central Dr Ste 1210, Dallas and it's customer support contact number is 702-360-2763. The authorized person of Southern California Dermatology is Lucius Blanchard, M.D. who is Owner/physician of the pharmacy and his contact number is 702-360-2763. Active license number of Southern California Dermatology is C53342 for Procedural Dermatology in California. Southern California Dermatology accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance. Southern California Dermatology is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
Pharmacy Details:
Southern California Dermatology type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name:
Southern California Dermatology
Type:
Procedural Dermatology
Location:
12700 Park Central Dr Ste 1210, Dallas, Texas, 75251-1522
Phone:
702-360-2763
Fax:
949-783-2880
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name:
Lucius Blanchard
Credentials:
M.D.
Position:
Owner/physician
Contact Number:
702-360-2763
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number:
1932154788
Parent Organization:
J Robert West, M.d., Inc
NPI Enumeration Date:
23 May, 2006
NPI Last Update On:
26 Mar, 2024
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southern California Dermatology are as mentioned below.
Specialization
License Number
State
Status
Procedural Dermatology
C53342
California
Primary
Dermatology
Secondary
Procedural Dermatology
G4302
California
Secondary
Dermatopathology
G4302
California
Secondary
Dermatopathology
C53342
California
Secondary
Non-pharmacy Dispensing Site
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
CG5410
Other
Nevada
Railroad Medicare
ZZZ24828Z
Other
California
Blue Shield Provider Numb
ZZZ24833Z
Other
California
Blue Shield Provider Numb
CA7620
Other
California
Railroad Medicare
CD5363
Other
California
Railroad Medicare
Medicare Enrollment:
Southern California Dermatology is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID:
Enrollment ID:
Org Name
Medicare Entity Type
8729990973
O20031105000239
J Robert West Md Inc
PART B SUPPLIER - CLINIC/GROUP PRACTICE
8729990973
O20040527000772
J Robert West Md Inc
PART B SUPPLIER - CLINIC/GROUP PRACTICE
8729990973
O20090813000213
J Robert West Md Inc
PART B SUPPLIER - CLINIC/GROUP PRACTICE
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
12700 Park Central Dr Ste 1210, Dallas, Texas
Zip:
75251-1522
Phone Number:
702-360-2763
Fax Number:
949-783-2880
Patients can reach Southern California Dermatology at 12700 Park Central Dr Ste 1210, Dallas, Texas or can call on customer care at 702-360-2763.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 May, 2024.