# AWAKENMD PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AwakenMD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922458439
- **Authorized official:** MR. SEAN E BOURKE M.D. (FOUNDER AND MEDICAL DIRECTOR)
- **Authorized official phone:** (650) 274-6256

## Contact information

- **Practice address:** 95 TOWN AND COUNTRY VILLAGE, PALO ALTO, CA 94301-2341
- **Practice address phone:** (650) 251-4722
- **Practice address fax:** (650) 421-7494
- **Mailing address:** 36 STANFORD SHOPPING CENTER, PALO ALTO, CA 94304-1423
- **Mailing address phone:** (650) 251-4722
- **Mailing address fax:** (650) 421-7494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/15/2016
- **Last updated:** 06/15/2016