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General NPI Number Information
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NPI Number | 1275076325
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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 | 11/22/2016
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 5800 HOLLIS ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-2016
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Country | US
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Telephone | 650-498-5785
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 HOLLIS ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-2016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR MANAGER
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Name | LARUE PERKINS
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Credential |
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Telephone | 650-498-5785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #9
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #10
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #11
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #12
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #13
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #14
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 070000662
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License Number State | CA
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Taxonomy #15
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 070000662
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License Number State | CA
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