Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | G12424 | CA |
NPI | 1285661496 |
---|---|
Provider Name | Dr. Leon W Lipson |
First Address | Palo Alto, CA 94306-1054 |
Second Address | Palo Alto, CA 94306-1054 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 07/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040003493 | MEDICARE RAILROAD (01) | CA |
A38670 | (02) | CA |