Healthcare Provider Details

I. General information

NPI: 1194870311
Provider Name (Legal Business Name): O & O ALPAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 OAKMONT AVE
BETHESDA MD
20817-3527
US

IV. Provider business mailing address

5511 OAKMONT AVE
BETHESDA MD
20817-3527
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-6002
  • Fax: 301-530-7424
Mailing address:
  • Phone: 240-643-6002
  • Fax: 301-530-7424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberD0052272
License Number StateMD

VIII. Authorized Official

Name: ORAL ALPAN
Title or Position: MANAGER
Credential: M.D.
Phone: 240-643-6002