Provider Demographics
NPI:1972898799
Name:FASSETT, MARLYS S (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MARLYS
Middle Name:S
Last Name:FASSETT
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Gender:F
Credentials:MD PHD
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Mailing Address - Street 1:1701 DIVISADERO ST FL 3
Mailing Address - Street 2:UCSF DERMATOLOGY
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3011
Mailing Address - Country:US
Mailing Address - Phone:415-353-7800
Mailing Address - Fax:415-353-7870
Practice Address - Street 1:1701 DIVISADERO ST FL 3
Practice Address - Street 2:UCSF DERMATOLOGY
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3011
Practice Address - Country:US
Practice Address - Phone:415-353-7800
Practice Address - Fax:415-353-7870
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2015-04-06
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Provider Licenses
StateLicense IDTaxonomies
CAA124742207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology