Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | G057912 | CA |
NPI | 1821179391 |
---|---|
Provider Name | Dr. Brian Steven Lipson |
First Address | Redwood City, CA 94063-1729 |
Second Address | Rewood City, CA 94063-1729 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AL3085291 | DEA (01) | CA |
E27933 | (02) | |
G057912 | CA LICENSE (01) | CA |