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Organization

J ROBERT WEST, M.D., INC

Active
Parent organization
J ROBERT WEST, M.D., INC
Other names
WEST DERMATOLOGY AND SURGERY MEDICAL GROUP, West Dermatology, SOUTHERN CALIFORNIA DERMATOLOGY
Organization subpart
Yes

Provider details

NPI number
Legal business name
J ROBERT WEST, M.D., INC
Authorized official
LUCIUS BLANCHARD M.D. (OWNER/PHYSICIAN)
(214) 618-6123
Entity
Organization

Contact information

Practice address
400 NEWPORT CENTER DR STE 702, NEWPORT BEACH, CA 92660-7669
(949) 644-0101
(949) 644-1868
Mailing address
9900 N CENTRAL EXPY STE 500, DALLAS, TX 75231-0928
(214) 987-3376
(469) 532-0273

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207NS0135X
Procedural Dermatology Physician
C53342
CA
207NS0135X
Procedural Dermatology Physician
G4302
CA
207ZD0900X
Dermatopathology (Pathology) Physician
C53342
CA
207ZD0900X
Dermatopathology (Pathology) Physician
G4302
CA
332900000X
Non-Pharmacy Dispensing Site

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CA7620
RAILROAD MEDICARE
CA
01
CD5363
RAILROAD MEDICARE
CA
01
CG5410
RAILROAD MEDICARE
NV
01
ZZZ24828Z
BLUE SHIELD PROVIDER NUMB
CA
01
ZZZ24833Z
BLUE SHIELD PROVIDER NUMB
CA
Enumeration date
05/23/2006
Last updated
05/12/2026
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