Healthcare Provider Details

I. General information

NPI: 1730347105
Provider Name (Legal Business Name): GIA J. OH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR ROOM G306
STANFORD CA
94305-2200
US

IV. Provider business mailing address

300 PASTEUR DR ROOM G306
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-724-0353
  • Fax:
Mailing address:
  • Phone: 650-724-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA106104
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberMD189913
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: