Provider Demographics
NPI:1285808691
Name:KNOTT, HAYDEE (MD)
Entity type:Individual
Prefix:DR
First Name:HAYDEE
Middle Name:
Last Name:KNOTT
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 1:655 REDWOOD HWY FRONTAGE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3031
Mailing Address - Country:US
Mailing Address - Phone:415-389-1018
Mailing Address - Fax:
Practice Address - Street 1:655 REDWOOD HWY #210
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941
Practice Address - Country:US
Practice Address - Phone:415-634-8411
Practice Address - Fax:844-880-4434
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117344207N00000X
OH57.008390207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology