Individual provider Active NPI

Pamela Stewart Rand, M.D.

  • Dermatology Physician
  • Santa Monica, CA
National Provider Identifier
1942450812
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G34247 Issued in CA
Practice address
1260 15TH St Ste 1109
Santa Monica, CA 90404-1146
Phone
(310) 395-5635
Fax
(310) 395-5205
NPI assigned
Sep 26, 2008
Last updated
Sep 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G34247 CA Primary

Addresses

Primary practice location

1260 15TH St Ste 1109
Santa Monica, CA 90404-1146

Mailing address

1260 15TH St Ste 1109
Santa Monica, CA 90404-1146
Phone (310) 395-5635

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
I20240508002512 CA Order and Referring Only - DermatologyPractitioner - Dermatology 7012358047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34247CAMDDermatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1942450812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 15TH ST STE 1109",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041146",
            "telephone_number": "310-395-5635",
            "fax_number": "310-395-5205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 15TH ST STE 1109",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041146",
            "telephone_number": "310-395-5635",
            "fax_number": "310-395-5205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAND",
        "first_name": "PAMELA",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G34247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.