Healthcare Provider Details

I. General information

NPI: 1174710545
Provider Name (Legal Business Name): ROBERT E MAYLE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR RM R144 STANFORD ORTHOPAEDIC SURGERY
STANFORD CA
94305-5341
US

IV. Provider business mailing address

300 PASTEUR DR RM R144 STANFORD ORTHOPAEDIC SURGERY
STANFORD CA
94305-5341
US

V. Phone/Fax

Practice location:
  • Phone: 650-725-5903
  • Fax: 650-724-3044
Mailing address:
  • Phone: 650-725-5903
  • Fax: 650-724-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA98952
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: