Provider Demographics
NPI:1851469282
Name:MAAS, COREY S (MD)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:S
Last Name:MAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2400 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1809
Mailing Address - Country:US
Mailing Address - Phone:415-567-7000
Mailing Address - Fax:415-567-7011
Practice Address - Street 1:2400 CLAY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1809
Practice Address - Country:US
Practice Address - Phone:415-567-7000
Practice Address - Fax:415-567-7011
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2013-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG711632086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE65813Medicare UPIN
CA00G711630Medicare ID - Type Unspecified