Healthcare Provider Details

I. General information

NPI: 1285821223
Provider Name (Legal Business Name): GEOFFREY DAVID ABRAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 650-725-5903
  • Fax: 650-724-3044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA105050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: