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Individual

ALLEN DAVID BOTT

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3120 WEBSTER ST, OAKLAND, CA 94609-3421
(510) 834-1813
(510) 834-9221
Mailing address
3120 WEBSTER ST, OAKLAND, CA 94609-3421
(510) 834-1813
(510) 834-9221

Taxonomy

Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G27329
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G273290
CA
Enumeration date
09/07/2005
Last updated
11/20/2019
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