Presidio Dermatology, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G53235 Issued in CA

Legal business name

PRESIDIO DERMATOLOGY, INC

Practice address

3905 Sacramento St
Suite 303
San Francisco, CA 94118-1636

Phone

(415) 933-8490

NPI assigned

Jun 18, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Amelia Hewitt Kaymen, MD

Title

President and Ceo

Phone

(415) 933-8490

Specialties & licenses 1

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1750720264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 SACRAMENTO ST",
            "address_2": "SUITE 303",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181636",
            "telephone_number": "415-933-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 SACRAMENTO ST",
            "address_2": "SUITE 303",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181636",
            "telephone_number": "415-933-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDIO DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KAYMEN",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_middle_name": "HEWITT",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "415-933-8490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G53235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven L Prenzlauer, MD
• Daniel Preocanin, P.T.
• Maximo Robert Prescott
• Presencelearning, Inc.
• Present Moment Wellness, Professional Corporation: Licensed Clinical Social Worker
• Presidio Health Services, LLC
• Presidio Psychotherapy
• Presidio Sport & Medicine, Inc.
• Presidio Surgery Center, LLC
• Presidio Therapy Services, LLC

• Dermatology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.