Organization
ADVANCED MEDICAL AND SURGICAL DERMATOLOGY CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANYA BANDT M.D. (PRESIDENT)
(415) 259-0131
Entity
Organization
Contact information
Practice address
1099 D ST STE 204, SAN RAFAEL, CA 94901-2893
(415) 259-0131
(415) 259-0133
Mailing address
1099 D ST STE 204, SAN RAFAEL, CA 94901-2893
(415) 259-0131
(415) 259-0133
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A65185
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A65186
CA
207ND0900X
Dermatopathology Physician
A65186
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
A65186
CA
207NS0135X
Procedural Dermatology Physician
A65186
CA
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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