Organization
DMAT CA-6
Active
Other names
CDMSA
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIPIN (UNIT COMMANDER)
(292) 731-3755
Entity
Organization
Contact information
Practice address
520 LOOP RD, BLDG 4, A-137, PALO ALTO, CA 94304-1207
(202) 731-3755
(650) 412-1815
Mailing address
101 DALE AVE, SAN CARLOS, CA 94070-2940
(202) 731-3755
(650) 412-1815
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
G64161
CA
251V00000X
Voluntary or Charitable Agency
G64161
CA
Other
Enumeration date
01/29/2016
Last updated
08/27/2016
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