Provider Demographics
NPI:1730386533
Name:LA BARBARA, ALLYSON M (MD)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:M
Last Name:LA BARBARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3490 CALIFORNIA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1892
Mailing Address - Country:US
Mailing Address - Phone:415-514-6200
Mailing Address - Fax:415-514-6410
Practice Address - Street 1:3490 CALIFORNIA ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1892
Practice Address - Country:US
Practice Address - Phone:415-514-6200
Practice Address - Fax:415-514-6410
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics