Organization
CALIFORNIA DERMATOLOGY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN NEIL LEDESMA M.D. (OWNER)
(310) 360-6661
Entity
Organization
Contact information
Practice address
23525 GOLDEN SPRINGS DR, DIAMOND BAR, CA 91765-2175
(909) 860-7600
Mailing address
602 N ROXBURY DR, BEVERLY HILLS, CA 90210-3228
(310) 200-8705
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
G44761
CA
207ND0101X
MOHS-Micrographic Surgery Physician
G44761
CA
207ND0900X
Dermatopathology Physician
G44761
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
G44761
CA
207NP0225X
Pediatric Dermatology Physician
G44761
CA
207NS0135X
Procedural Dermatology Physician
Primary
G44761
CA
Other
Enumeration date
06/26/2006
Last updated
09/11/2025
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