Skip to content

Desert Valley Dermatology PLC

NPI 1124739560ActiveOrganization· Dermatology, MOHS-Micrographic Surgery· Phoenix, AZ

Dermatology, MOHS-Micrographic Surgery in Phoenix, Arizona, registered in NPPES in December 2022. The authorized official on file is Travis Lam, DO, Member. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1124739560
StatusActive
Entity typeOrganization
NPI issuedDec 7, 2022
Last updated in NPPESSep 10, 2026
Certified by providerSep 10, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Dermatology, MOHS-Micrographic Surgery Primary207ND0101X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (AZ)

Medicare sources and data years

Other Dermatology, MOHS-Micrographic Surgery providers in Phoenix

All Dermatology, MOHS-Micrographic Surgery providers in Arizona