Provider Demographics
NPI:1881819019
Name:VANZANDER, JOELLEN LEE (MD)
Entity Type:Individual
Prefix:
First Name:JOELLEN
Middle Name:LEE
Last Name:VANZANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOELLEN
Other - Middle Name:VANZANDER
Other - Last Name:STOFFEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:321 MIDDLEFIELD RD STE 260
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4010
Mailing Address - Country:US
Mailing Address - Phone:650-498-6500
Mailing Address - Fax:
Practice Address - Street 1:321 MIDDLEFIELD RD STE 260
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4010
Practice Address - Country:US
Practice Address - Phone:650-498-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102997207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology