Fairmont Dermatology Medical Associates Inc
NPI 1477729291 · Dermatology Physician · Lodi, CA
Fairmont Dermatology Medical Associates Inc is a Dermatology Physician organization in Lodi, CA (NPI 1477729291).
Provider details
- NPI number
- 1477729291
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Fairmont Dermatlogy Medical Associates Inc
- Organization subpart
- Yes
- Authorized official
- Abdallah Khourdaji, President(209) 333-6110
- License
- 00A341430 (CA)
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
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Other names (DBA / former)
- Doing business as
- Abdallah Khourdaji
Registry dates
- Enumerated
- 2008-05-01
- Last updated
- 2008-06-13
Frequently asked questions
- What is Fairmont Dermatology Medical Associates Inc's NPI number?
- Fairmont Dermatology Medical Associates Inc's National Provider Identifier (NPI) is 1477729291, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fairmont Dermatology Medical Associates Inc?
- Fairmont Dermatology Medical Associates Inc is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Fairmont Dermatology Medical Associates Inc located?
- Fairmont Dermatology Medical Associates Inc's practice location on file with NPPES is 801 S Ham Ln Ste a, Lodi, CA 95242-7502.
- What is Fairmont Dermatology Medical Associates Inc's phone number?
- The practice phone number listed in the NPPES registry for Fairmont Dermatology Medical Associates Inc is (209) 333-6110.
- Who is the authorized official for Fairmont Dermatology Medical Associates Inc?
- The authorized official listed on Fairmont Dermatology Medical Associates Inc's NPPES record is Abdallah Khourdaji, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fairmont Dermatology Medical Associates Inc's NPI active?
- Yes — Fairmont Dermatology Medical Associates Inc's NPI (1477729291) is active in the NPPES registry as of the last update on 2008-06-13.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.