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General NPI Number Information
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NPI Number | 1285177337
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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 | 6121 HOLLIS ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-2077
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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 | 6121 HOLLIS ST
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City | EMERYVILLE
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State | CA
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Zip | 94608-2077
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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 | 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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