Provider Demographics
NPI:1821179391
Name:LIPSON, BRIAN STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEVEN
Last Name:LIPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 MAIN ST .
Mailing Address - Street 2:200
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1729
Mailing Address - Country:US
Mailing Address - Phone:650-216-6111
Mailing Address - Fax:
Practice Address - Street 1:369 MAIN ST.
Practice Address - Street 2:200
Practice Address - City:REWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1729
Practice Address - Country:US
Practice Address - Phone:650-216-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG057912207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG057912OtherCA LICENSE
CAG057912OtherCA LICENSE
CAG057912OtherCA LICENSE
CAAL3085291OtherDEA