Healthcare Provider Details

I. General information

NPI: 1629625264
Provider Name (Legal Business Name): MEREDITH HUTTON MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 08/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
PALO ALTO CA
94305-2200
US

IV. Provider business mailing address

1940 WEBSTER ST
PALO ALTO CA
94301-4047
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 650-665-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA164517
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: