Immunetech Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 11721 Issued in CA

Legal business name

IMMUNETECH INC

Practice address

373 Vintage Park Dr Ste a
Foster City, CA 94404-1139

Phone

(650) 312-1066

Fax

(650) 350-3283

NPI assigned

Oct 29, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Elkins

Title

Chief Executive Officer

Phone

(415) 717-8064

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1952601593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3856 BAY CENTER PL",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945453619",
            "telephone_number": "650-312-1066",
            "fax_number": "888-275-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 VINTAGE PARK DR STE A",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041139",
            "telephone_number": "650-312-1066",
            "fax_number": "650-350-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNETECH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-29",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "ELKINS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "415-717-8064"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 11721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Leigh Howard, MD
• Ruth V Huckaby, RDHAP
• Christine Chuang Hung, M.D.
• Juliet Hunter
• Amira Mahmoud Husseiny
• Jacklyn Kurth Orthodontics Inc
• Diane Jacobs, D.D.S.
• Mark A Jadallah, DDS
• Valerie Krieger Jahan, M.D.
• Sripriya Jayaraman, MPH, DDS

• Clinical Medical Laboratory in Foster City, CA
• Providers in Foster City, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.