Provider Demographics
NPI:1922312248
Name:COMPASS DERMATOPATHOLOGY, INC.
Entity Type:Organization
Organization Name:COMPASS DERMATOPATHOLOGY, INC.
Other - Org Name:SKYMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DERMATOPATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOANELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-750-2983
Mailing Address - Street 1:6605 NANCY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2253
Mailing Address - Country:US
Mailing Address - Phone:858-900-2712
Mailing Address - Fax:858-750-2984
Practice Address - Street 1:6605 NANCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2253
Practice Address - Country:US
Practice Address - Phone:858-900-2712
Practice Address - Fax:858-750-2984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADU128AOtherMEDICARE PTAN