Organization Active NPI

David a Laub MD, a Professional Corporation

  • Dermatology Physician
  • Mill Valley, CA
National Provider Identifier
1366556797
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G58416 Issued in CA
Legal business name
DAVID A LAUB MD, A PROFESSIONAL CORPORATION
Practice address
591 Redwood Hwy
Suite 2210
Mill Valley, CA 94941-6003
Phone
(415) 381-6661
Fax
(415) 381-6695
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Mrs. Barbara E Finley
Title
Medical Biller
Phone
(707) 869-2681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X G58416 CA Primary

Addresses

Primary practice location

591 Redwood Hwy
Suite 2210
Mill Valley, CA 94941-6003

Mailing address

591 Redwood Hwy
Suite 2210
Mill Valley, CA 94941-6003
Phone (415) 381-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080502000439 CA Part B Supplier - Clinic/Group Practice 7719066687 Receives reassigned benefits from 2 practitioners
Practice locations: Mill Valley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0937820David a Laub MD591 Redwood Hwy, Ste 2210, Mill Valley, CA 94941ComplianceNov 29, 2026

National Provider Directory

National Provider Directory

Locations

591 Redwood Hwy Frontage Rd
Ste 2210
Mill Valley, CA 94941
Phone (415) 381-6661

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1366556797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 REDWOOD HWY",
            "address_2": "SUITE 2210",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949416003",
            "telephone_number": "415-381-6661",
            "fax_number": "415-789-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 REDWOOD HWY",
            "address_2": "SUITE 2210",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949416003",
            "telephone_number": "415-381-6661",
            "fax_number": "415-381-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A LAUB MD, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "707-869-2681",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G58416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.