Organization
DANIEL BEHROOZAN MD A MEDICAL CORPORATION
Active
Other names
Dermatology Institute of Southern California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL BEHROOZAN MD (PRESIDENT)
(310) 392-1111
Entity
Organization
Contact information
Practice address
2221 LINCOLN BLVD, #100, SANTA MONICA, CA 90405-1320
(310) 392-1111
(310) 392-1101
Mailing address
2221 LINCOLN BLVD, #100, SANTA MONICA, CA 90405-1320
(310) 392-1111
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A76756
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A76756
CA
207NS0135X
Procedural Dermatology Physician
A76756
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W20251
MEDICARE GROUP ID
CA
Enumeration date
12/15/2006
Last updated
06/09/2025
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