| Skymd | |
|
6605 Nancy Ridge Dr San Diego CA 92121-2253 | |
| (858) 900-2712 | |
| (858) 750-2984 |
| Full Name | Skymd |
|---|---|
| Speciality | Dermatology |
| Location | 6605 Nancy Ridge Dr, San Diego, California |
| Authorized Official Name and Position | Antoanella Calame (DERMATOPATHOLOGIST) |
| Authorized Official Contact | 8587502983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skymd 6605 Nancy Ridge Dr San Diego CA 92121-2253 Ph: (858) 900-2712 | Skymd 6605 Nancy Ridge Dr San Diego CA 92121-2253 Ph: (858) 900-2712 |
| NPI Number | 1922312248 |
|---|---|
| Provider Enumeration Date | 07/28/2010 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Medicare PECOS PAC ID | 7113112558 |
|---|---|
| Medicare Enrollment ID | O20101111000762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922312248 | NPI | - | NPPES |
| DU128A | Other | CA | MEDICARE PTAN |
| Provider Name | Robert Peppercorn |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588655823 PECOS PAC ID: 5193620441 Enrollment ID: I20051122000775 |
| Provider Name | Shannon L Webb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821271685 PECOS PAC ID: 9133271521 Enrollment ID: I20090715000788 |
| Provider Name | Antoanella Calame |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1285817569 PECOS PAC ID: 2860545134 Enrollment ID: I20101117000116 |
| Provider Name | Lisa Ann Stirling |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1063685410 PECOS PAC ID: 1557539228 Enrollment ID: I20110725000078 |
| Provider Name | Christopher Erickson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1093993263 PECOS PAC ID: 6608943972 Enrollment ID: I20150903002882 |
| Provider Name | Devika P Icecreamwala |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639444748 PECOS PAC ID: 5496987968 Enrollment ID: I20171031003045 |
| Provider Name | Kevin Wright |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1164700738 PECOS PAC ID: 3678803814 Enrollment ID: I20200430002804 |
| Provider Name | Nikki D Tang |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740574169 PECOS PAC ID: 1153609011 Enrollment ID: I20200612002431 |
| Provider Name | Anna Chacon |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1073950689 PECOS PAC ID: 8527207919 Enrollment ID: I20210611002404 |
| Provider Name | Jane Yoon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912249913 PECOS PAC ID: 3971739962 Enrollment ID: I20210930002740 |
| Provider Name | Kara Smolinski |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1710007026 PECOS PAC ID: 6002805686 Enrollment ID: I20220606001315 |
| Provider Name | Blake Galler |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1265705933 PECOS PAC ID: 2860762879 Enrollment ID: I20220707002692 |
| Provider Name | Willis Lyford |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1760877633 PECOS PAC ID: 1052706397 Enrollment ID: I20221223001237 |
| Provider Name | Jean-phillip Okhovat |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1497103105 PECOS PAC ID: 0941595862 Enrollment ID: I20230202002028 |
| Provider Name | Matthew C Willett |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1720328107 PECOS PAC ID: 8426383480 Enrollment ID: I20230609002552 |
| Provider Name | Vienna Grayce Katana |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1871832881 PECOS PAC ID: 2264811389 Enrollment ID: I20230628000680 |
| Provider Name | Danielle Fasciano |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1376997668 PECOS PAC ID: 7719265206 Enrollment ID: I20230731002398 |
| Provider Name | Daniel Gonzalez |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1336672716 PECOS PAC ID: 4587066675 Enrollment ID: I20231130002142 |
| Provider Name | Bina Adigopula |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982686200 PECOS PAC ID: 5698125094 Enrollment ID: I20231227003124 |
| Provider Name | Michael Lee |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1457988750 PECOS PAC ID: 7416477468 Enrollment ID: I20250221000344 |
| Provider Name | Shadi Khalil |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1366901688 PECOS PAC ID: 0446799902 Enrollment ID: I20250829004264 |
| Provider Name | Rudy Franklin Schmiedecke |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1427398296 PECOS PAC ID: 0749669216 Enrollment ID: I20250912003577 |
| Provider Name | Blake Vest |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1891311403 PECOS PAC ID: 8022433960 Enrollment ID: I20250925004023 |
| Provider Name | Anne Allen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1083143226 PECOS PAC ID: 0345509592 Enrollment ID: I20250925004354 |
| Provider Name | Luke Maxfield |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1144681255 PECOS PAC ID: 1850669151 Enrollment ID: I20260317004746 |
| Provider Name | Michael Welsch |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1932175767 PECOS PAC ID: 8820017205 Enrollment ID: I20260320000035 |
| Provider Name | Eduardo Rodriguez |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508354127 PECOS PAC ID: 5890151120 Enrollment ID: I20260327002948 |
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