Provider Demographics
NPI:1265651780
Name:MARNA M SKAAR MD INC
Entity Type:Organization
Organization Name:MARNA M SKAAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SKAAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-342-5667
Mailing Address - Street 1:50 S SAN MATEO DR STE 280
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3859
Mailing Address - Country:US
Mailing Address - Phone:650-342-5667
Mailing Address - Fax:650-342-7590
Practice Address - Street 1:50 S SAN MATEO DR STE 280
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3859
Practice Address - Country:US
Practice Address - Phone:650-342-5667
Practice Address - Fax:650-342-7590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38325676174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E81994Medicare UPIN
00G561040Medicare ID - Type Unspecified