OrganizationActive
Golden Coast Dermatology, Skin Cancer and Vein Center PC
NPI 1053957456 · MOHS-Micrographic Surgery Physician · Mission Viejo, CA
Provider details
- NPI number
- 1053957456
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Tidwell, Owner/Physician(270) 933-2109
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
26732 Crown Valley Pkwy Ste 571
Mission Viejo, CA 92691-7305
Phone: (270) 933-2109
Approximate (ZIP-level) locationGet directions
Mailing address
26732 Crown Valley Pkwy Ste 571
Mission Viejo, CA 92691-7305
Registry dates
- Enumerated
- 2019-11-20
- Last updated
- 2020-03-27
- Certified
- 2020-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.