Healthcare Provider Details

I. General information

NPI: 1972820686
Provider Name (Legal Business Name): MARGARET ANNE VARTANIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1422 EL CAMINO REAL
MENLO PARK CA
94025-4110
US

IV. Provider business mailing address

1422 EL CAMINO REAL
MENLO PARK CA
94025-4110
US

V. Phone/Fax

Practice location:
  • Phone: 650-903-9500
  • Fax: 650-903-9900
Mailing address:
  • Phone: 650-903-9500
  • Fax: 650-903-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA119998
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA119998
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: