Healthcare Provider Details

I. General information

NPI: 1346770567
Provider Name (Legal Business Name): ALLERGY AND ASTHMA CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 MAIN ST STE 200
REDWOOD CITY CA
94063-1759
US

IV. Provider business mailing address

369 MAIN ST STE 200
REDWOOD CITY CA
94063-1759
US

V. Phone/Fax

Practice location:
  • Phone: 650-216-6111
  • Fax:
Mailing address:
  • Phone: 650-216-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberG057912
License Number StateCA

VIII. Authorized Official

Name: DR. BRIAN LIPSON
Title or Position: MEDICAL DOCTOR
Credential:
Phone: 650-216-6111