Healthcare Provider Details

I. General information

NPI: 1235974700
Provider Name (Legal Business Name): ANYWHERE CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD STE 246
MILL VALLEY CA
94941-3055
US

IV. Provider business mailing address

4029 DEAN MARTIN DR
LAS VEGAS NV
89103-4138
US

V. Phone/Fax

Practice location:
  • Phone: 702-848-2256
  • Fax:
Mailing address:
  • Phone: 702-848-2256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAM ZAND
Title or Position: OWNER
Credential: DO
Phone: 702-919-1508