Maddox, John L.
Maddox, John L. is an individual health care provider with primary practice located at 1300 S Eliseo Dr Ste 207 , Greenbrae CA 94904-2015. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Maddox, John L. can be contacted via phone (415) 925-0550.Contact Information
Primary practice address
1300 S Eliseo Dr Ste 207
Greenbrae CA 94904-2015
Phone: (415) 925-0550
Fax: (415) 925-9062
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G40606 | California |
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | G40606 | California |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | G40606 | California |
Profile Details
| NPI number | 1790837508 |
|---|---|
| LBN Legal business name | Maddox, John L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jul 1st, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790837508 | NPPES |
| California | MEDICAID | 00G406060 |
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