Provider Demographics
NPI:1700907813
Name:AMERICAN LUNG ASSOCIATION OF CALIFORNIA
Entity Type:Organization
Organization Name:AMERICAN LUNG ASSOCIATION OF CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FULTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-893-5474
Mailing Address - Street 1:1900 POWELL ST
Mailing Address - Street 2:800
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1811
Mailing Address - Country:US
Mailing Address - Phone:510-893-5474
Mailing Address - Fax:
Practice Address - Street 1:1900 POWELL ST
Practice Address - Street 2:800
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1811
Practice Address - Country:US
Practice Address - Phone:510-893-5474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare