Basic Information
| Provider Information | |||||||||
| NPI: | 1598141566 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STANFORD HEALTHCARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 247 ARRIBA DR | ||||||||
| Address2: | APT 2 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940866976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502858340 | ||||||||
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| Practice Location | |||||||||
| Address1: | 777 WELCH RD | ||||||||
| Address2: | SUITE DE | ||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943041613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507236661 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2015 | ||||||||
| LastUpdateDate: | 07/31/2015 | ||||||||
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| AuthorizedOfficialLastName: | DOHN | ||||||||
| AuthorizedOfficialFirstName: | ANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | GME COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 6507235948 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.