Provider Demographics
NPI:1285676551
Name:BADAME, ANTHONY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:BADAME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2025 FOREST AVE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4806
Mailing Address - Country:US
Mailing Address - Phone:408-297-4200
Mailing Address - Fax:408-297-2503
Practice Address - Street 1:2025 FOREST AVE
Practice Address - Street 2:SUITE 9
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4806
Practice Address - Country:US
Practice Address - Phone:408-297-4200
Practice Address - Fax:408-297-2503
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA46257207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D0608454OtherCLIA
CAE72056Medicare UPIN