Direct Dermatology Professionals PC
NPI 1417263922 · Dermatology Physician · Manteca, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Direct Dermatology Professionals PC is a Dermatology Physician organization in Manteca, CA (NPI 1417263922).
Provider details
- NPI number
- 1417263922
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Wong, President(855) 944-7546
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 5305 N Fresno St Ste 105Fresno, CA 93710-6845Phone: (510) 241-2884Fax: (800) 572-0683
Registry dates
- Enumerated
- 2010-08-20
- Last updated
- 2024-11-06
- Certified
- 2024-11-06
Frequently asked questions
- What is Direct Dermatology Professionals PC's NPI number?
- Direct Dermatology Professionals PC's National Provider Identifier (NPI) is 1417263922, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Direct Dermatology Professionals PC?
- Direct Dermatology Professionals PC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Direct Dermatology Professionals PC located?
- Direct Dermatology Professionals PC's practice location on file with NPPES is 165 Saint Dominics Dr Ste 120, Manteca, CA 95337-7802.
- What is Direct Dermatology Professionals PC's phone number?
- The practice phone number listed in the NPPES registry for Direct Dermatology Professionals PC is (510) 241-2884.
- Does Direct Dermatology Professionals PC accept Medicare?
- Direct Dermatology Professionals PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Direct Dermatology Professionals PC?
- The authorized official listed on Direct Dermatology Professionals PC's NPPES record is David Wong, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Direct Dermatology Professionals PC's NPI active?
- Yes — Direct Dermatology Professionals PC's NPI (1417263922) is active in the NPPES registry as of the last update on 2024-11-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.