Advanced Medical And Surgical Dermatology Corporation
Dermatology in San Rafael, CA. Organization (NPI-2).
NPI number1720370166
StatusActive
Last updated in NPPESMay 4, 2011
Details
- NPI
- 1720370166
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Medical And Surgical Dermatology Corporation
- Organization subpart
- No
- Enumeration date
- May 4, 2011
- Last updated
- May 4, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | A65185 | CA | Yes |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | A65186 | CA | |
| 207ND0900X | Dermatology, Dermatopathology | A65186 | CA | |
| 207NI0002X | Dermatology, Clinical & Laboratory Dermatological Immunology | A65186 | CA | |
| 207NS0135X | Dermatology, Procedural Dermatology | A65186 | CA |
Practice location
1099 D St Ste 204San Rafael, CA 94901-2893
Phone 415-259-0131 · Fax 415-259-0133
Mailing address
1099 D St Ste 204San Rafael, CA 94901-2893
Phone 415-259-0131 · Fax 415-259-0133
Authorized official
Anya Bandt
President
4152590131
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