Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc
Organization Active NPI Dermatology Physician · Mill Valley, CA
NPI 1700879079 · NPPES record last updated Jul 29, 2020
Key facts
- NPI
- 1700879079
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- AESTHETIC DERMATOLOGY & COSMETIC SURGERY MEDICAL ASSOCIATES, INC
- Practice address
- 535 Miller Ave
Mill Valley, CA 94941-2905 - Phone
- (415) 383-5486
- Fax
- (415) 389-7455
- NPI assigned
- Aug 23, 2005
- Organization subpart
- No
Authorized official
- Name
- Jeffrey H Binstock, MD
- Title
- Owner
- Phone
- (415) 383-5486
Other NPIs on the same Medicare enrollment 1
Practitioners 3
-
Mira Noble, NP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031112000267 | CA | Part B Supplier - Clinic/Group Practice | 9537072830 |
Receives reassigned benefits from 3 practitioners 2 other NPIs on this enrollment Practice locations: Mill Valley, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
535 Miller Ave
Mill Valley, CA 94941-2905
Mailing address
535 Miller Ave
Mill Valley, CA 94941-2905
Phone (415) 383-5486
Other providers in Mill Valley, CA
- Ismail Abdolahi
- Bryan C. Abrams
- Antone Roger Abuyaghi
- Adam P. Nelson, MD
- Aesthetic Dermatology & Cosmetic Surgery Medical Associates, Inc
- Ashley Aguilera
- Catherine Ainsworth
- Albani Group Family and Child Therapy Inc. Dba the Albani Group
- Alpha Neuro-Monitoring, LLC
- Alta Mira Recovery Centers, LLC
All providers in Mill Valley, CA · Dermatology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.