Organization
R MAKALA ANDERS MD MEDICAL CORPORATION
Active
Organization
R MAKALA ANDERS MD MEDICAL CORPORATION
Active
Other names
Reuben Makala Anders MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REUBEN MAKALA ANDERS MD (OWNER)
(707) 938-1423
Entity
Organization
Contact information
Practice address
461 7TH ST W STE 3, SONOMA, CA 95476-5976
(707) 938-1423
Mailing address
461 7TH ST W STE 3, SONOMA, CA 95476-5976
(707) 938-1423
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A79025
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A79025
CA
207ND0900X
Dermatopathology Physician
A79025
CA
207NS0135X
Procedural Dermatology Physician
A79025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A790251
MEDICARE PTAN
CA
01
—
BI781
MEDICARE PTAN
CA
Enumeration date
11/18/2008
Last updated
04/17/2023
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