Crane Street Dermatology

Key facts

NPI

1801293154

Entity type

Organization (NPI type 2)

Primary specialty

Dermatology Physician 207N00000X

Legal business name

CRANE STREET DERMATOLOGY

Practice address

1225 Crane St
Suite 102
Menlo Park, CA 94025-4257

Phone

(650) 323-0276

Fax

(702) 921-6828

NPI assigned

Dec 2, 2014

Organization subpart

No

Authorized official

Name

Recia Blumenkranz, MD

Title

President

Phone

(650) 323-0276

Practitioners 5

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

• Audrey Szep Fetch, M.D. Dermatology Physician · Menlo Park, CA · NPI 1093158495
  Medicare reassignment Care Compare group NPD CA · DERMATOLOGY
• Mary Sheu, MD Dermatology Physician · Menlo Park, CA · NPI 1659338705
  Medicare reassignment Care Compare group NPD CA · DERMATOLOGY
• Qisi Sun, MD Dermatology Physician · Palo Alto, CA · NPI 1093396665
  Medicare reassignment Care Compare group NPD CA · DERMATOLOGY
• Mark Blumenkranz, M.D. Ophthalmology Physician · Stanford, CA · NPI 1114085636
  NPD (past)
• Melinda Ann Longaker, MD Clinical & Laboratory Dermatological Immunology Physician · Menlo Park, CA · NPI 1902997430
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 2, 2014.

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1801293154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "SUITE 102",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-323-0276",
            "fax_number": "702-921-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CRANE ST",
            "address_2": "SUITE 102",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254257",
            "telephone_number": "650-323-0276",
            "fax_number": "702-921-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANE STREET DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "BLUMENKRANZ",
        "authorized_official_first_name": "RECIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-323-0276",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

• County of San Mateo
• Couples Institute Counseling Services a Marriage and Family Therapy Co
• Kimberly Michelle Courtney, PT, DPT
• Pamela Louise Courtright
• Mayra Leon Cramer, M.S., CCC-SLP
• Caroline Cranwell-Calleros, RPH
• Eric Floyd Crawford, PH.D.
• Shannon David Crawford, MD
• Diane Melissa Criscuolo, NP
• Cristina Cojocaru, DO, a PC

All providers in Menlo Park, CA · Dermatology Physician in California