Shala Fardin (NPI# 1720114432, PAC ID# 6800978164) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1720114432 |
| PAC ID by PECOS | 6800978164 |
| Professional Enrollment ID | I20090715000698 |
| Full Name | Shala Fardin |
| Organization Legal Name | SOUTHERN MARIN DERMATOLOGY INC |
| Address |
2330 Marinship Way Suite 370 Sausalito CA 94965-2853 |
| Phone Number | 4158879758 |
| Gender | F |
| Medical School | HARVARD MEDICAL SCHOOL |
| Graduation Year | 2003 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2668614447 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 | 4158879758 | SOUTHERN MARIN DERMATOLOGY INC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_047_overall | Care Plan | 74% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 1% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 91% |
| Organization Legal Name | SOUTHERN MARIN DERMATOLOGY INC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley A Smith | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Holly L Christman | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Suzanne L Westphal | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Sara Marxmiller | Nurse Practitioner | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Street Address |
2330 MARINSHIP WAY SUITE 370 |
| City | SAUSALITO |
| State | CA |
| Zip | 94965-2853 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley A Smith | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Holly L Christman | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Suzanne L Westphal | Dermatology | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Sara Marxmiller | Nurse Practitioner | Southern Marin Dermatology Inc | 2330 Marinship Way, Suite 370, Sausalito, CA 94965-2853 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Martin J Borge | Chiropractic | 221 'b' St, Pt. Reyes Station, CA 94965-0965 | |
| Carianne Blomquist | Family Medicine | 630 Drake Ave, Sausalito, CA 94965-1107 | |
| Colin Spake | Nurse Practitioner | Marin City Health and Wellness Center | 630 Drake Ave, Sausalito, CA 94965-1107 |
| Lawrence Posner | Internal Medicine | Prima Medical Foundation | 3 Harbor Dr, Suite 111, Sausalito, CA 94965-1491 |
| Domingo Guevara Aviado | Family Practice | Prima Medical Foundation | 3 Harbor Dr, Sausalito, CA 94965-1491 |
| Maureen L Mccoy | Optometry | 33 Caledonia St, Sausalito, CA 94965-2116 | |
| Lori S Rodgers | Chiropractic | 1000 Bridgeway, Suite C, Sausalito, CA 94965-2173 | |
| Naureen A Shaikh | Internal Medicine | 111 2nd St, Sausalito, CA 94965-2526 | |
| Eva M Dahl | Chiropractic | 475 Gate 5 Rd, Sausalito, CA 94965-2879 | |
| Nancy A Hollis | Chiropractic | 3 Gate 5 Rd A, Sausalito, CA 94965-2889 | |
| Find all physicians in zip 94965 | |||
| City | SAUSALITO |
| Zip Code | 94965 |
| Specialty | DERMATOLOGY |
| City + Specialty | SAUSALITO + DERMATOLOGY |
Please comment or provide details below to improve the information on Shala Fardin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.