Provider Demographics
NPI:1942450812
Name:RAND, PAMELA STEWART (MD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:STEWART
Last Name:RAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 15TH ST STE 1109
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1146
Mailing Address - Country:US
Mailing Address - Phone:310-395-5635
Mailing Address - Fax:310-395-5205
Practice Address - Street 1:1260 15TH ST STE 1109
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1146
Practice Address - Country:US
Practice Address - Phone:310-395-5635
Practice Address - Fax:310-395-5205
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34247207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology