Provider Demographics
NPI:1932181575
Name:LIPSON, SCOTT ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:ANDREW
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 1:1300 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4260
Mailing Address - Country:US
Mailing Address - Phone:888-924-1036
Mailing Address - Fax:
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG706272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G7062711Medicare PIN
CA00G7062718Medicare PIN
CA00G7062715Medicare PIN
CA00G7062716Medicare PIN
CA00G7062722Medicare PIN
CA00G706278Medicare PIN
CAP00479844Medicare PIN
CA00G7062712Medicare PIN
CA00G7062721Medicare PIN
CA00G706271Medicare PIN
CA00G7062713Medicare PIN
CA00G7062720Medicare PIN
CA00G706276Medicare PIN
F80227Medicare UPIN
CA00G7062717Medicare PIN
CA00G7062719Medicare PIN
CA00G706272Medicare PIN
CAP00331119Medicare PIN
CA00G706279Medicare PIN
CA00G70627100Medicare PIN
CA00G7062714Medicare PIN
CA00G706273Medicare PIN
CA00G706275Medicare PIN
CA00G706277Medicare PIN