Healthcare Provider Details

I. General information

NPI: 1861588030
Provider Name (Legal Business Name): VIVIEN ABAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 HANOVER STREET STANFORD HOSPITAL AND CLINICS
PALO ALTO CA
94304-1117
US

IV. Provider business mailing address

PO BOX 3006
LOS ALTOS CA
94024-0006
US

V. Phone/Fax

Practice location:
  • Phone: 650-721-7557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA36892
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: