Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Misty Eleryan, MD

Individual provider Dermatology Physician · NPI 1588989412

Dr. Misty Eleryan, MD is a Dermatology in Marina del Rey, California. Qualified in 2010, 16 years ago. Practices with Sanford Medical Center Fargo, a 1,212-clinician group and accepts Medicare assignment. Licensed in Arizona, California and North Dakota.

Years since qualifying
16
Licensed in
AZ, CA, ND
In the registry since
2010
Specialties on file
6
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

13157 Mindanao Way # 329
Marina del Rey, CA 90292-6307
Phone: (310) 564-2782
Fax: (310) 564-2782
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence A168938 (CA)
Dermatology Physician Taxonomy 207N00000X · Licence 70096 (AZ)
Dermatology Physician Taxonomy 207N00000X · Licence 22506 (ND)
Dermatology Physician Taxonomy 207N00000X · Licence A168938 (CA)
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X · Licence 70096 (AZ)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence A168938 (CA)

Record details

NPI number1588989412
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 4, 2010
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Sanford Medical Center Fargo — 1212 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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