Healthcare Provider Details

I. General information

NPI: 1306425475
Provider Name (Legal Business Name): GAZEBO HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

13521 WILDCREST DR
LOS ALTOS HILLS CA
94022-3433
US

V. Phone/Fax

Practice location:
  • Phone: 650-714-2411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NORMAN LANCELOT DOWNING
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 650-714-2411