Healthcare Provider Details

I. General information

NPI: 1306810197
Provider Name (Legal Business Name): MARY M HALPIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HOSPITAL DRIVE BLDG 12
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

2500 HOSPITAL DRIVE BLDG 12
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-968-1605
  • Fax: 650-968-4542
Mailing address:
  • Phone: 650-968-1605
  • Fax: 650-968-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA54561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: