Active NPI 1790983237 Individual Practitioner Male Practitioner

Dr. Benjamin Joseph Nichols , MD

Dermatology • Greenbrae, CA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Nichols, MD is a certified Dermatology practicing in Greenbrae, CA. With approximately 21 years of clinical experience since graduating from University Of Southern California Keck School Of Medicine in 2005, Dr. Nichols delivers high-quality medical care to the local community at 1300 S ELISEO DR.

Dr. Nichols is affiliated with Greenbrae Dermatology, A Medical Corporation and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1300 S Eliseo Dr
Suite 207

Greenbrae, CA 949042023

Telephone 4159250550

Fax 4159259062

Associated Practice Facility / Clinic

🏢 James E Shepard Mark C Lambert & Lawrence A Levy Ptrs Facility NPI 1063500825

Medicare Profile & Education

Medical School

University Of Southern California Keck School Of Medicine

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Greenbrae, CA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs Matches City Avg

City Avg: 21.0 Yrs

State Avg: 24.9 Yrs

Regional Practice Density

3 Specialists

Practicing in Greenbrae, CA (2182 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

42.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Nichols (21 Years) 21 Yrs

Greenbrae Specialty Average (21.0 Years) 21.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,365	639	$68.90	$9.39
99213 Established patient office or other outpatient visit, typically 15 minutes	1,725	1,116	$241.58	$115.54
17000 Destruction of skin growth	959	758	$211.48	$77.55
17004 Destruction of precancer skin growth, 15 or more growths	458	323	$382.62	$227.45
11102 Tangential biopsy of single skin lesion	422	370	$273.39	$132.40
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	403	302	$356.39	$162.04
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	364	18	$216.94	$174.89
17110 Destruction of up to 14 skin growths	284	258	$294.66	$155.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	192	192	$175.46	$139.63
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	167	135	$91.36	$72.92
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	143	127	$607.78	$388.49
96574 Application of light with debridement to destroy precancer skin growth	104	95	$493.12	$397.14
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	77	71	$511.50	$412.36
11103 Biopsy of related skin growth, each additional growth	76	57	$184.94	$68.88
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	73	32	$5.00	$0.98
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	41	40	$407.65	$164.51
11900 Injection into skin growth, 1-7 growths	34	28	$194.47	$64.31
96573 Application of light by qualified health care professional to destroy precancer skin growth	31	30	$510.70	$323.95
69100 Biopsy of ear	27	26	$160.55	$109.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$350.33	$200.46
10060 Simple or single drainage of skin abscess	23	19	$211.31	$169.69
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	23	22	$459.53	$185.49
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	11	$289.73	$116.87
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$441.37	$178.04
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	11	11	$298.25	$227.59
99202 New patient office or other outpatient visit, typically 20 minutes	11	11	$116.30	$92.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,592	635	$53.25	$8.94
99213 Established patient office or other outpatient visit, typically 15 minutes	1,491	997	$160.88	$109.11
17000 Destruction of skin growth	976	751	$130.67	$74.45
11102 Tangential biopsy of single skin lesion	416	354	$193.21	$127.89
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	361	17	$212.59	$164.14
17004 Destruction of precancer skin growth, 15 or more growths	340	249	$298.14	$217.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	319	251	$226.24	$153.25
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	245	214	$90.22	$69.62
17110 Destruction of up to 14 skin growths	238	219	$210.95	$145.96
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	183	183	$174.25	$134.37
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	97	90	$532.84	$384.59
11103 Biopsy of related skin growth, each additional growth	82	67	$104.43	$65.49
96573 Application of light by qualified health care professional to destroy precancer skin growth	79	73	$429.56	$316.57
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	68	64	$508.52	$389.46
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	62	23	$2.02	$1.06
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	44	40	$404.86	$159.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$278.01	$197.80
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	25	24	$456.68	$183.10
11900 Injection into skin growth, 1-7 growths	25	19	$130.47	$61.17
99202 New patient office or other outpatient visit, typically 20 minutes	23	23	$115.05	$88.67
69100 Biopsy of ear	19	19	$161.21	$114.44
10060 Simple or single drainage of skin abscess	16	16	$206.89	$154.70
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	15	15	$296.18	$228.69
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	14	11	$296.44	$187.75
11104 Punch biopsy, first skin growth	12	11	$214.21	$165.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,970	646	$19.28	$8.89
99213 Established patient office or other outpatient visit, typically 15 minutes	1,452	986	$149.99	$108.43
17000 Destruction of skin growth	987	752	$113.95	$73.97
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	482	19	$197.67	$161.06
11102 Tangential biopsy of single skin lesion	454	387	$177.80	$126.30
17004 Destruction of precancer skin growth, 15 or more growths	311	226	$275.21	$215.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	234	194	$193.12	$152.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	232	196	$84.32	$68.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	182	182	$178.73	$132.44
17110 Destruction of up to 14 skin growths	178	159	$196.17	$142.69
11103 Biopsy of related skin growth, each additional growth	70	56	$104.34	$64.99
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	60	58	$519.59	$377.10
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	59	55	$490.86	$388.52
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	45	26	$3.37	$1.12
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	31	29	$302.21	$200.68
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	31	29	$410.40	$154.22
96574 Application of light with debridement to destroy precancer skin growth	30	30	$495.57	$381.36
11900 Injection into skin growth, 1-7 growths	26	25	$96.09	$53.80
96573 Application of light by qualified health care professional to destroy precancer skin growth	26	26	$373.76	$318.78
10060 Simple or single drainage of skin abscess	24	22	$205.94	$156.68
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	24	23	$482.37	$174.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	23	23	$271.27	$196.76
69100 Biopsy of ear	22	22	$171.34	$107.02
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	20	18	$247.72	$159.94
99202 New patient office or other outpatient visit, typically 20 minutes	20	20	$124.22	$88.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,885	590	$12.23	$8.41
99213 Established patient office or other outpatient visit, typically 15 minutes	1,351	929	$131.53	$108.03
17000 Destruction of skin growth	915	676	$120.00	$72.08
11102 Tangential biopsy of single skin lesion	418	353	$185.00	$131.01
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	400	16	$175.00	$160.59
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	273	241	$77.00	$67.65
17004 Destruction of precancer skin growth, 15 or more growths	227	164	$269.00	$207.67
17110 Destruction of up to 14 skin growths	190	156	$205.00	$143.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	136	136	$187.00	$132.26
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	101	40	$5.00	$1.28
11103 Biopsy of related skin growth, each additional growth	88	63	$130.00	$67.03
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	69	63	$547.00	$380.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	65	55	$186.00	$152.83
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	55	48	$455.00	$390.09
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	43	40	$443.00	$154.28
99202 New patient office or other outpatient visit, typically 20 minutes	42	42	$131.00	$87.09
96574 Application of light with debridement to destroy precancer skin growth	39	36	$487.00	$381.12
11900 Injection into skin growth, 1-7 growths	36	29	$99.00	$52.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	34	25	$48.00	$17.16
10060 Simple or single drainage of skin abscess	32	32	$209.00	$147.93
69100 Biopsy of ear	26	25	$183.00	$95.78
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	24	24	$502.00	$173.77
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	16	14	$313.00	$201.95
96573 Application of light by qualified health care professional to destroy precancer skin growth	13	12	$365.00	$313.10

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,906	516	$10.00	$7.70
99213 Established patient office or other outpatient visit, typically 15 minutes	1,290	930	$127.00	$88.63
17000 Destruction of skin growth	772	634	$120.00	$71.23
11102 Tangential biopsy of single skin lesion	324	288	$185.00	$121.17
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	275	11	$175.00	$153.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	225	198	$77.00	$54.79
17110 Destruction of up to 14 skin growths	206	189	$205.00	$140.73
17004 Destruction of precancer skin growth, 15 or more growths	178	145	$269.00	$196.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	125	114	$186.00	$127.15
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$187.00	$127.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	108	41	$5.00	$1.48
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	64	61	$547.00	$356.26
99202 New patient office or other outpatient visit, typically 20 minutes	59	59	$131.00	$90.59
11103 Biopsy of related skin growth, each additional growth	45	40	$130.00	$66.76
11900 Injection into skin growth, 1-7 growths	41	34	$99.00	$53.56
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	41	37	$455.00	$391.57
96574 Application of light with debridement to destroy precancer skin growth	31	27	$487.00	$347.86
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	30	29	$443.00	$152.05
10060 Simple or single drainage of skin abscess	25	25	$209.00	$148.47
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	23	23	$502.00	$172.51
69100 Biopsy of ear	17	16	$183.00	$108.19
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	16	15	$524.00	$327.53
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	15	13	$483.00	$165.23
96573 Application of light by qualified health care professional to destroy precancer skin growth	15	15	$365.00	$278.81
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	12	12	$457.00	$157.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,534	403	$10.00	$6.80
99213 Established patient office or other outpatient visit, typically 15 minutes	991	677	$127.00	$86.87
17000 Destruction of skin growth	695	509	$120.00	$69.85
11102 Tangential biopsy of single skin lesion	239	196	$185.00	$117.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	187	187	$187.00	$125.86
17110 Destruction of up to 14 skin growths	184	158	$205.00	$136.44
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	167	142	$77.00	$53.83
17004 Destruction of precancer skin growth, 15 or more growths	141	105	$269.00	$183.16
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	123	90	$186.00	$126.82
99202 New patient office or other outpatient visit, typically 20 minutes	67	67	$131.00	$89.87
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	57	30	$5.00	$1.61
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	50	49	$547.00	$369.40
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	29	27	$443.00	$154.58
11900 Injection into skin growth, 1-7 growths	27	24	$99.00	$55.49
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	23	$483.00	$190.76
10060 Simple or single drainage of skin abscess	23	22	$209.00	$142.59
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	20	20	$524.00	$342.74
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	19	17	$455.00	$389.63
17111 Destruction of skin growth, 15 or more growths	16	15	$240.00	$160.34
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	14	$502.00	$169.28
11103 Biopsy of related skin growth, each additional growth	14	14	$127.86	$65.46
11104 Punch biopsy, first skin growth	14	14	$225.00	$147.81
96573 Application of light by qualified health care professional to destroy precancer skin growth	13	12	$365.00	$259.60
69100 Biopsy of ear	13	12	$183.00	$110.40
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	11	11	$427.00	$298.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,286	333	$10.00	$6.03
99213 Established patient office or other outpatient visit, typically 15 minutes	822	562	$127.03	$81.64
17000 Destruction of skin growth	584	406	$120.00	$68.87
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	209	172	$77.00	$49.98
11100 Biopsy of single growth of skin and/or tissue	199	167	$188.00	$121.51
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	139	139	$187.00	$119.80
17110 Destruction of up to 14 skin growths	133	111	$205.00	$132.39
17004 Destruction of precancer skin growth, 15 or more growths	121	86	$269.00	$165.43
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	83	37	$5.00	$1.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	78	62	$186.05	$120.05
99202 New patient office or other outpatient visit, typically 20 minutes	76	76	$131.00	$84.42
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	45	39	$547.00	$342.26
88305 Pathology examination of tissue using a microscope, intermediate complexity	42	33	$129.14	$69.22
11900 Injection into skin growth, 1-7 growths	37	30	$99.00	$55.98
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	24	23	$443.00	$142.78
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	18	18	$524.00	$307.96
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	17	$483.00	$164.14
11101 Biopsy of each additional growth of skin and/or tissue	17	11	$57.00	$36.19
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	14	$502.00	$161.85
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	11	11	$457.00	$147.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,456	235	$10.00	$6.50
99213 Established patient office or other outpatient visit, typically 15 minutes	621	427	$127.00	$82.06
17000 Destruction of skin growth	416	308	$120.00	$69.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	212	176	$77.00	$49.81
11100 Biopsy of single growth of skin and/or tissue	201	175	$188.00	$118.40
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	123	123	$187.00	$120.38
17110 Destruction of up to 14 skin growths	94	78	$205.00	$131.35
88305 Pathology examination of tissue using a microscope, intermediate complexity	84	63	$124.75	$73.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	70	52	$186.09	$120.39
17004 Destruction of precancer skin growth, 15 or more growths	61	39	$269.00	$172.92
99202 New patient office or other outpatient visit, typically 20 minutes	56	56	$131.00	$84.44
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	48	24	$5.00	$1.82
11101 Biopsy of each additional growth of skin and/or tissue	34	27	$57.00	$36.39
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	30	29	$547.00	$345.31
11900 Injection into skin growth, 1-7 growths	22	20	$99.00	$55.37
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	19	18	$443.00	$157.61
10060 Simple or single drainage of skin abscess	15	14	$209.00	$134.76
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	14	14	$311.79	$306.82
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	14	14	$265.00	$168.97
12031 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.5 cm or less	11	11	$427.00	$249.41

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License CA A97389

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Greenbrae Dermatology, A Medical Corporation

1300 S Eliseo Dr, Greenbrae, CA 949042015

Phone: 4159250550

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Cheryl Tanasovich , MD

Dermatology - Procedural Dermatology

NPI 1215960844

Doctor of Medicine (M.D.)

Dr. John Maddox , MD

Dermatology

NPI 1790837508

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

✅

NPI Profile Active October 11, 2017

NPI status registered as active in NPPES database

📍

Updated Practice Location October 11, 2017

Registered at 1300 S ELISEO DR, SUITE 207, GREENBRAE, CA 949042023 (Tel: 4159250550)

📍

Updated Business Mailing Address October 11, 2017

Registered at 1300 S ELISEO DR, SUITE 207, GREENBRAE, CA 949042023 (Tel: 4159250550)

👤

Provider Name / Credentials Updated October 11, 2017

Recorded as BENJAMIN NICHOLS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2017

Dermatology (License #A97389 in CA)

✅

NPI Profile Active October 20, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location October 20, 2016

Registered at 1300 S ELISEO DR, SUITE 207, GREENBRAE, CA 949042023 (Tel: 4159250550)

📍

Updated Business Mailing Address October 20, 2016

Registered at 1300 S ELISEO DR, SUITE 207, GREENBRAE, CA 949042023 (Tel: 4159250550)

👤

Provider Name / Credentials Updated October 20, 2016

Recorded as BENJAMIN NICHOLS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 20, 2016

Dermatology (License #A97389 in CA)

🟢

Initial NPI Registration & Enumeration July 05, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1790983237

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 05, 2007

Last Update: October 11, 2017

Sole Proprietor: No

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Mailing Address

1300 S Eliseo Dr, Suite 207

Greenbrae, CA 949042023

Phone: 4159250550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.