Marin Dermatology Associates

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A65186 Issued in CA

Legal business name

MARIN DERMATOLOGY ASSOCIATES

Practice address

1660 2ND St
San Rafael, CA 94901-2707

Phone

(415) 259-0131

Fax

(415) 259-0133

NPI assigned

Apr 16, 2009

Last updated

Mar 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Anya E Bandt, M.D.NPI 1750401998

Title

President

Phone

(415) 259-0131

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anya Elizabeth Bandt, M.D.

  • Dermatology Physician
  • Medford, OR
  • NPI 1750401998
  NPD Authorized official

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

{
    "created_epoch": "1239840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1841433182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 COMMERCE ST",
            "address_2": "SUITE B",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949541469",
            "telephone_number": "707-778-7862",
            "fax_number": "707-778-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 2ND ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012707",
            "telephone_number": "415-259-0131",
            "fax_number": "415-259-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN DERMATOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-16",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "BANDT",
        "authorized_official_first_name": "ANYA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-259-0131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A65186",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "A65186",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A65186",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A65186",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marin County Juvenile Probation
• Marin County Office of Education
• Marin County Public Health
• Marin County TCM Program
• Marin Creates Dba Enterprise Resource Center
• Marin Family Recovery
• Marin General Hospital
• Marin Health Ventures, LLC (Marin Specialty Surgery Center)
• Marin Healthcare District
• Marin Hills Medical Group Inc

• Dermatology Physician in San Rafael, CA
• Providers in San Rafael, 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 10, 2011; 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.