Basic Information
| Provider Information | |||||||||
| NPI: | 1124057252 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PAO | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | CHUN-YAO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 780 WELCH ROAD | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943045851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504984809 | ||||||||
| FaxNumber: | 6507211443 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 PASTEUR DR | ||||||||
| Address2: | |||||||||
| City: | STANFORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943052200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6504985710 | ||||||||
| FaxNumber: | 6504985840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 04/25/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A75186 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | A75186 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 00A751860 | 05 | CA | MEDICAID |