Provider Demographics
NPI:1285661496
Name:LIPSON, LEON W (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:W
Last Name:LIPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1691 EL CAMINO REAL
Mailing Address - Street 2:STE 400
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1054
Mailing Address - Country:US
Mailing Address - Phone:650-329-9100
Mailing Address - Fax:650-631-2448
Practice Address - Street 1:1691 EL CAMINO REAL
Practice Address - Street 2:STE 400
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1054
Practice Address - Country:US
Practice Address - Phone:650-631-8300
Practice Address - Fax:650-631-2448
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2017-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG12424207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA040003493OtherMEDICARE RAILROAD
CA040003493OtherMEDICARE RAILROAD
CAEC463ZMedicare PIN