Healthcare Provider Details

I. General information

NPI: 1083521009
Provider Name (Legal Business Name): ROBERT EVAN LASH MD
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

567 CANYON RD
REDWOOD CITY CA
94062-3019
US

IV. Provider business mailing address

567 CANYON RD
REDWOOD CITY CA
94062-3019
US

V. Phone/Fax

Practice location:
  • Phone: 650-888-2372
  • Fax:
Mailing address:
  • Phone: 650-888-2372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: