Individual provider Active NPI

Marion Dean Anthony, M.D.

  • Specialist
  • Pleasanton, CA
National Provider Identifier
1679577563
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G36637 Issued in CA
Practice address
5575 W Las Positas Blvd
Ste 260
Pleasanton, CA 94588-5803
Phone
(925) 847-3020
Fax
(925) 847-8933
NPI assigned
Jun 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G36637 CA Primary

Addresses

Primary practice location

5575 W Las Positas Blvd
Ste 260
Pleasanton, CA 94588-5803

Mailing address

5575 W Las Positas Blvd
Ste 260
Pleasanton, CA 94588-5803
Phone (925) 847-3020

Other names 1

  • Dr. Dean Anthony Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100220000050 CA Practitioner - Dermatology 3173667763 Practice locations: Pleasanton, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G36637CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1679577563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "STE 260",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885803",
            "telephone_number": "925-847-3020",
            "fax_number": "925-847-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 W LAS POSITAS BLVD",
            "address_2": "STE 260",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945885803",
            "telephone_number": "925-847-3020",
            "fax_number": "925-847-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "MARION",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G36637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEAN",
            "last_name": "ANTHONY",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pleasanton, CA

Sources for this page

Verify at the official NPI Registry.