JOHN L. MADDOX (NPI# 1790837508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790837508 |
| Entity Type | Individual |
| Full Name | JOHN L. MADDOX |
| Credential | MD |
| Practice Address |
1300 S Eliseo Dr Ste 207 Greenbrae CA 94904-2015 |
| Practice Telephone | 4159250550 |
| Practice Fax Number | 4159259062 |
| Mailing Telephone | 4159250550 |
| Mailing Fax Number | 4159259062 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2015-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | G40606 | CA | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
G40606 | CA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
G40606 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G406060 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528122256 | John Specht Maddox | Surgery | Walter Reed National Military Ctr, 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2006-12-20 |
| 1467546648 | John F. Maddox IIi | Obstetrics & Gynecology | 3023 Hamaker Ct, Suite 210a, Fairfax, VA 22031-2222 | 2006-10-03 |
| 1477575868 | John F Maddox | Family Medicine | 835 S Three Notch St, Andalusia, AL 36420-5321 | 2006-07-24 |
| 1104801208 | John Mark Maddox | Surgery | 315 Martin Luther King Jr Way, Tacoma, WA 98405-4234 | 2005-12-12 |
| 1801887229 | John L Maddox | Pediatrics | 500 Salem St, Wilmington, MA 01887-1200 | 2005-11-03 |
| 1053309542 | John Coulter Maddox | Pathology | 500 J Clyde Morris Blvd, Newport News, VA 23601-1929 | 2005-10-10 |
| 1487640801 | John Alton Maddox | Dentist | 8076b Spring Run Rd, Fairhope, AL 36532-3854 | 2005-09-21 |
| Street Address |
1300 S ELISEO DR STE 207 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904-2015 |
| 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 |
|---|---|---|---|---|
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790983237 | Benjamin Joseph Nichols | Dermatology | 1300 S Eliseo Dr, Suite 207, Greenbrae, CA 94904-2023 | 2007-07-05 |
| 1366530099 | Parnell Medical Corporation | Dermatology | 1100 S Eliseo Dr, Suite 2, Greenbrae, CA 94904-2017 | 2006-10-10 |
| 1811926652 | Diana Deangelis Parnell | Dermatology | 1100 S Eliseo Dr, Suite 2, Greenbrae, CA 94904-2017 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
| Find all providers with the same taxonomy | ||||
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| 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.