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General NPI Number Information
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NPI Number | 1053835595
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Entity Type | Organization
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Legal Business Name | STANFORD HEALTH CARE
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 875 BLAKE WILBUR DR STE CC1102
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City | PALO ALTO
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State | CA
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Zip | 94304-2205
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Country | US
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Telephone | 650-736-3800
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Fax | 650-736-7991
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Provider Business Mailing Address
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Address Line | 875 BLAKE WILBUR DR STE CC1102
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City | PALO ALTO
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State | CA
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Zip | 94304-2205
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Country | US
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Telephone | 650-736-3800
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Fax | 650-736-7991
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR,PHARMACY SERVICE
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Name | HARI CHANDANA MULAMALLA
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Credential | PHARMD
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Telephone | 312-215-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 55482
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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