Organization
MARIN DERMATOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANYA E BANDT M.D. (PRESIDENT)
(415) 259-0131
Entity
Organization
Contact information
Practice address
1660 2ND ST, SAN RAFAEL, CA 94901-2707
(415) 259-0131
(415) 259-0133
Mailing address
1310 COMMERCE ST, SUITE B, PETALUMA, CA 94954-1469
(707) 778-7862
(707) 778-0969
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A65186
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A65186
CA
207ND0900X
Dermatopathology Physician
A65186
CA
207NS0135X
Procedural Dermatology Physician
A65186
CA
Other
Enumeration date
04/16/2009
Last updated
03/10/2011
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