Individual
DR. KENNETH W. LIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20400 LAKE CHABOT RD, STE. 304, CASTRO VALLEY, CA 94546-5316
(510) 537-0700
(510) 537-7795
Mailing address
20400 LAKE CHABOT RD STE 304, STE. 304, CASTRO VALLEY, CA 94546-5316
(510) 537-0700
(510) 537-7795
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
A72098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396823092
—
CA
01
—
CA110780
GRP PTAN FOR ALLERGY, ASTHMA & SINUS CENTERS OF SILICON VALLEY
CA
01
—
EK627Z
INDIVIDUAL MEDICARE PTAN
CA
Enumeration date
11/01/2006
Last updated
02/03/2014
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