Basic Information
| Provider Information | |||||||||
| NPI: | 1598059651 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYNCH | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 232410 | ||||||||
| Address2: | APT #12 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921932410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582496749 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1180 BEACON ST | ||||||||
| Address2: | SUITE1B | ||||||||
| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024463885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172781700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 02/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 260946 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A146262 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.