Coastal Medical and Cosmetic Dermatology Inc
NPI 1346488004ActiveOrganization· Dermatology· La Jolla, CA
Dermatology in La Jolla, California, registered in NPPES in February 2009. The authorized official on file is Darrell Wayne Gonzales, M.D., Owner, President, Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1346488004 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 3, 2009 |
| Last updated in NPPES | Dec 17, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | A88738 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
Other Dermatology providers in La Jolla
- 1942709738
- 1154008662
- 1750394508
- 1003202409
- 1669465951
- 1144753468
- 1588989487
- 1760473664
- 1306103924
- 1417960188
- 1407084908
- 1861413296