Provider Demographics
NPI:1114077526
Name:STANFORD HOSPITAL AND CLINICS
Entity Type:Organization
Organization Name:STANFORD HOSPITAL AND CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-723-5708
Mailing Address - Street 1:750 WELCH RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1507
Mailing Address - Country:US
Mailing Address - Phone:650-498-5691
Mailing Address - Fax:650-498-5692
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:RM. A160
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-6961
Practice Address - Fax:650-725-8418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG079013174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG079013OtherMEDICAL LICENSE
BN4336471OtherDEA