HOLLAND, BETSY A (MD)

Provider Demographics

• NPI: 1659357481
• Name: HOLLAND, BETSY A (MD)
• Entity Type: Individual
• Prefix: DR
• First Name: BETSY
• Middle Name: A
• Last Name: HOLLAND
• Gender: F
• Credentials: MD
• Mailing Address - Street 1: PO BOX 6102
• Mailing Address - City: NOVATO
• Mailing Address - State: CA
• Mailing Address - Zip Code: 94948-6102
• Mailing Address - Country: US
• Mailing Address - Phone: 415-884-3415
• Mailing Address - Fax: 415-883-0877
• Practice Address - Street 1: 1260 S ELISEO DR
• Practice Address - Street 2: SUITE 101
• Practice Address - City: GREENBRAE
• Practice Address - State: CA
• Practice Address - Zip Code: 94904-2009
• Practice Address - Country: US
• Practice Address - Phone: 415-464-8080
• Practice Address - Fax: 415-883-0877
• Is Sole Proprietor?: No
• Enumeration Date: 2005-12-22
• Last Update Date: 2020-05-13

Provider Licenses

State	License ID	Taxonomies
NE	24391	2085R0202X
CA	G46969	2085R0202X
OH	35-06-4062-H	2085R0202X
NY	214723-1	2085R0202X
OK	21437	2085R0202X
OR	MD25390	2085R0202X
TX	L1612	2085R0202X
WA	MD00032481	2085R0202X
AK	2033	2085R0202X
AZ	28860	2085R0202X
CO	30653	2085R0202X
IL	36103898	2085R0202X
MT	68	2085R0202X
NV	SP078	2085R0202X
NJ	MA71884	2085R0202X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	2085R0202X	Allopathic & Osteopathic Physicians	Radiology	Diagnostic Radiology

Provider Identifiers

State	Identifier ID	ID Type	Issuer
CO	1306539	Medicaid
NV	1659357481	Medicaid
CA	300121793	Other	RAILROAD MEDICARE
WA	8169658	Medicaid
OK	200097360A	Medicaid
AZ	P00457734	Other	RAILROAD MEDICARE
WA	300123268	Other	RAILROAD MEDICARE
AZ	867658	Medicaid
CA	00G469690	Medicaid
NJ	8940509	Medicaid
CA	00G4696914	Medicare PIN
NJ	051036	Medicare PIN
CA	00G469690	Medicaid
CA	CX118W	Medicare PIN
CA	CX118Y	Medicare PIN
CA	CX118Z	Medicare PIN
OK	200097360A	Medicaid
NJ	8940509	Medicaid
CA	CX118K	Medicare PIN
NV	1659357481	Medicaid
CA	CX118L	Medicare PIN
CA	CX118R	Medicare PIN
WA	300123268	Other	RAILROAD MEDICARE
WA	8169658	Medicaid
CO	CO300489	Medicare PIN
CA	00G4696913	Medicare PIN
AZ	P00457734	Other	RAILROAD MEDICARE
CA	CX118X	Medicare PIN
AZ	867658	Medicaid
NV	V105277	Medicare PIN
OK	00G469691	Medicare PIN
CA	00G469693	Medicare PIN
CA	CX118Q	Medicare PIN
CA	CX118U	Medicare PIN
CA	CX118Y	Medicare PIN
CA	00G4696915	Medicare PIN
CA	00G4696917	Medicare PIN
AZ	867658	Medicaid
CO	CO300489	Medicare PIN
AZ	Z81196	Medicare PIN
NE	281821	Medicare PIN