Provider Type Icon

ADVANCED MEDICAL AND SURGICAL DERMATOLOGY CORPORATION NPI 1720370166


NPI Information

NPI: 1720370166
Provider Name: ADVANCED MEDICAL AND SURGICAL DERMATOLOGY CORPORATION
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 05D0964093

Address:
1099 D ST STE 204
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 259-0131
Get Directions

ADVANCED MEDICAL AND SURGICAL DERMATOLOGY CORPORATION is a dermatology in San Rafael, CA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. ADVANCED MEDICAL AND SURGICAL DERMATOLOGY CORPORATION NPI is 1720370166. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1099 D ST STE 204
SAN RAFAEL, CA
ZIP 94901-893
Phone: (415) 259-0131
Fax: (415) 259-0133

The provider's authorized official is Anya Bandt .
The authorized official title is President and has the following contact phone number (415) 259-0131.

The CLIA number assigned to this NPI record is 05D0964093 - practitioner other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/4/2011 and was last updated on 5/4/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryA65186CALIFORNIANo
2207ND0900XDermatologyDermatopathologyA65186CALIFORNIANo
3207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyA65186CALIFORNIANo
4207NS0135XDermatologyProcedural DermatologyA65186CALIFORNIANo
5207N00000XDermatologyA65185CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.