Healthcare Provider Details

I. General information

NPI: 1750680302
Provider Name (Legal Business Name): NOVA M ISAAC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2011
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR RM H2200
STANFORD CA
94305-5281
US

IV. Provider business mailing address

300 PASTEUR DR RM H2200
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-4711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License NumberA111182
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: