CHERYL ANN TANASOVICH (NPI# 1215960844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215960844 |
| Entity Type | Individual |
| Full Name | CHERYL ANN TANASOVICH |
| Credential | M.D. |
| Practice Address |
1300 S Eliseo Dr Suite 207 Greenbrae CA 94904-2023 |
| Practice Telephone | 4159250550 |
| Practice Fax Number | 4159259062 |
| Mailing Telephone | 4159250550 |
| Mailing Fax Number | 4159259062 |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2007-07-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
G53455 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | AETNA PROVIDER NUMBER | 0004133440 | 01 |
| CA | BLUE SHIELD PROV # | 00G534550 | 01 |
| CA | RAILROAD MEDICARE PROV # | 070003525 | 01 |
| CA | MEDI-CAL PROVIDER NUMBER | 00G534551 | 01 |
| CA | TRICARE PROVIDER NUMBER | 931041613 | 01 |
| Street Address |
1300 S ELISEO DR SUITE 207 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904-2023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003887324 | David L Ogden | Internal Medicine | 1300 S Eliseo Dr, 203, Greenbrae, CA 94904-2023 | 2006-01-27 |
| 1376087882 | Gila C. Dorostkar, Dds, PC | Dentist | 1300 S Eliseo Dr, Suite 100, Greenbrae, CA 94904-2023 | 2016-12-19 |
| 1649667072 | Kwok Internal Medicine A Medical Corporation | Internal Medicine | 1300 S Eliseo Dr, Suite 203, Greenbrae, CA 94904-2023 | 2015-04-23 |
| 1780025361 | Marin Personalized Medicine, Inc. | Clinic/Center | 1300 S Eliseo Dr, Ste. # 203, Greenbrae, CA 94904-2023 | 2013-07-11 |
| 1225478936 | Cicely Brooke Smith | Dentist | 1300 S Eliseo Dr, Suite 100, Greenbrae, CA 94904-2023 | 2013-06-26 |
| 1629386867 | Mark Bazalgette, M.d., Inc. | Colon & Rectal Surgery | 1300 S Eliseo Dr, Suite 203, Greenbrae, CA 94904-2023 | 2010-09-22 |
| 1538489109 | Marin Nephrology | Internal Medicine | 1300 S Eliseo Dr, Suite 104, Greenbrae, CA 94904-2023 | 2010-06-07 |
| 1508007535 | Marin Surgical Associates | Surgery | 1300 S Eliseo Dr, Greenbrae, CA 94904-2023 | 2009-03-21 |
| 1699974899 | Anne M. Cummings, M.d. A Medical Corporation | Internal Medicine | 1300 S Eliseo Dr, Suite 201, Greenbrae, CA 94904-2023 | 2007-07-17 |
| 1558560482 | Genevieve Estilo | Internal Medicine | 1300 S Eliseo Dr, Suite 104, Greenbrae, CA 94904-2023 | 2007-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174898654 | Greenbrae Dermatology, A Medical Corporation | Dermatology | 1300 S Eliseo Dr Ste 207, Greenbrae, CA 94904-2015 | 2012-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578175006 | Lms Medical Services | Dermatology | 1118 N Mccadden Pl, Los Angeles, CA 90038-1213 | 2020-08-17 |
| 1932687241 | Silhouette Medical Group | Dermatology | 101 E Vineyard Ave Ste 107, Livermore, CA 94550-6877 | 2018-07-31 |
| 1780188482 | California Dermatology Physicians | Dermatology | 1902 Fullerton Ave # 102, Corona, CA 92881-3112 | 2018-03-19 |
| 1942709738 | Azadeh Shirazi Md Inc | Dermatology | 7301 Girard Ave Ste 202, La Jolla, CA 92037-5151 | 2018-02-07 |
| 1205342920 | Solano Dermatology Associates Inc | Dermatology | 1700 2nd St Ste 220, Napa, CA 94559-2455 | 2017-12-18 |
| 1831603901 | Laser Medspa, Inc. | Dermatology | 73655 El Paseo Ste N, Palm Desert, CA 92260-4304 | 2017-11-27 |
| 1326427204 | Jennifer Herrmann Md Inc | Dermatology | 421 N Rodeo Dr Ste 7, Beverly Hills, CA 90210-4514 | 2015-05-25 |
| 1235540196 | Microsurgery Goup | Dermatology | 21039 S Figueroa Ave Suite 201, Carson, CA 90745-7042 | 2014-05-14 |
| 1811261183 | Robert Ray Nettles | Dermatology | 8500 Wilshire Blvd Ste 630, Beverly Hills, CA 90211-3139 | 2012-03-02 |
| 1164748737 | Jane Chung | Dermatology | 895 E Fremont Ave Ste 201, Sunnyvale, CA 94087-2973 | 2010-04-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CHERYL ANN TANASOVICH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.