Healthcare Provider Details

I. General information

NPI: 1851553671
Provider Name (Legal Business Name): ALLON RAFAEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15075 LOS GATOS BLVD STE 150
LOS GATOS CA
95032-2050
US

IV. Provider business mailing address

1850 EL CAMINO REAL STE 200
BURLINGAME CA
94010-3102
US

V. Phone/Fax

Practice location:
  • Phone: 408-879-5900
  • Fax: 408-879-5901
Mailing address:
  • Phone: 650-697-2431
  • Fax: 650-697-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number140809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: