Lakeside Dermatology - a Professional Medical Corporation
NPI 1780963991 · Dermatology Physician · San Francisco, CA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Lakeside Dermatology - a Professional Medical Corporation is a Dermatology Physician organization in San Francisco, CA (NPI 1780963991).
Provider details
- NPI number
- 1780963991
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alice DO, President(415) 317-7261
- License
- 20A9018 (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
14 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
Registry dates
- Enumerated
- 2011-08-05
- Last updated
- 2020-10-06
- Certified
- 2020-10-06
Frequently asked questions
- What is Lakeside Dermatology - a Professional Medical Corporation's NPI number?
- Lakeside Dermatology - a Professional Medical Corporation's National Provider Identifier (NPI) is 1780963991, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lakeside Dermatology - a Professional Medical Corporation?
- Lakeside Dermatology - a Professional Medical Corporation is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Lakeside Dermatology - a Professional Medical Corporation located?
- Lakeside Dermatology - a Professional Medical Corporation's practice location on file with NPPES is 1 Shrader Street, San Francisco, CA 94117.
- What is Lakeside Dermatology - a Professional Medical Corporation's phone number?
- The practice phone number listed in the NPPES registry for Lakeside Dermatology - a Professional Medical Corporation is (415) 422-0000.
- Does Lakeside Dermatology - a Professional Medical Corporation accept Medicare?
- Lakeside Dermatology - a Professional Medical Corporation 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 Lakeside Dermatology - a Professional Medical Corporation?
- The authorized official listed on Lakeside Dermatology - a Professional Medical Corporation's NPPES record is Alice DO, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lakeside Dermatology - a Professional Medical Corporation's NPI active?
- Yes — Lakeside Dermatology - a Professional Medical Corporation's NPI (1780963991) is active in the NPPES registry as of the last update on 2020-10-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.