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General NPI Number Information
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NPI Number | 1548773286
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Entity Type | Organization
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Legal Business Name | ZAND DERMATOLOGY INC
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 07/09/2020
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Provider Practice Location Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 246
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City | MILL VALLEY
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State | CA
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Zip | 94941-3055
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Country | US
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Telephone | 415-301-5000
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Fax | 844-719-5148
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Provider Business Mailing Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 246
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City | MILL VALLEY
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State | CA
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Zip | 94941-3055
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Country | US
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Telephone | 415-301-5000
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Fax | 844-719-5148
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LUCRETIA ANN LEWITT
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Credential |
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Telephone | 415-925-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A97783
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License Number State | CA
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