# CALIFORNIA DERMATOLOGY INSTITUTE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265397574
- **Authorized official:** NAVID EZRA (PRESIDENT)
- **Authorized official phone:** (805) 222-5803

## Contact information

- **Practice address:** 862 MEINECKE AVE STE 202, SAN LUIS OBISPO, CA 93405-3705
- **Practice address phone:** (805) 298-7034
- **Practice address fax:** (805) 298-7139
- **Mailing address:** 3095 OLD CONEJO RD STE 200, THOUSAND OAKS, CA 91320-2130
- **Mailing address phone:** (805) 298-7034
- **Mailing address fax:** (805) 298-7139

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 12/18/2025
- **Last updated:** 12/18/2025