R Makala Anders MD Medical Corporation

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A79025 Issued in CA

Legal business name

R MAKALA ANDERS MD MEDICAL CORPORATION

Practice address

461 7TH St W Ste 3
Sonoma, CA 95476-5976

Phone

(707) 938-1423

NPI assigned

Nov 18, 2008

Last updated

Apr 17, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Reuben Makala Anders, MDNPI 1922029271

Title

Owner

Phone

(707) 938-1423

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Reuben Makala Anders MD Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Reuben Makala Anders, MD

  • Dermatology Physician
  • Sonoma, CA
  • NPI 1922029271
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Dagmar Wilkens, PA

  • Physician Assistant
  • San Pablo, CA
  • NPI 1558384057
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1003061078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 7TH ST W STE 3",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765976",
            "telephone_number": "707-938-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 7TH ST W STE 3",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954765976",
            "telephone_number": "707-938-1423"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Beard Rd",
            "address_purpose": "LOCATION",
            "city": "Napa",
            "state": "CA",
            "postal_code": "945583470",
            "country_code": "US",
            "telephone_number": "707-252-2914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "R MAKALA ANDERS MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "MAKALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-938-1423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A79025",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A79025",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A79025",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A79025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "BI781",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00A790251",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reuben Makala Anders MD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Reuben Makala Anders MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Prima Medical Foundation
• Prima Medical Foundation
• Prima Medical Foundation
• Cynthia Lena Psaila, LMFT
• Ralph Steven Pulverman, D.O.
• Alex Rainow, MD
• Richard Allen Raley, M.D.
• Ralph T. Mitarai, M.D., Professional Corporation
• Rabab Rangwala
• Claire Rase, FNP

• Dermatology Physician in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.