Provider Demographics
NPI: | 1740469725 |
---|---|
Name: | TOWER DERMATOLOGY PC |
Entity type: | Organization |
Organization Name: | TOWER DERMATOLOGY PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHILLINGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 310-659-9075 |
Mailing Address - Street 1: | 8631 W 3RD ST |
Mailing Address - Street 2: | SUITE 1035 |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90048-5901 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-659-9075 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 8631 W 3RD ST |
Practice Address - Street 2: | SUITE 1035 |
Practice Address - City: | LOS ANGELES |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90048-5901 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-659-9075 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-10-26 |
Last Update Date: | 2025-07-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | W21620 | Medicare UPIN |