Provider Demographics
NPI:1275653586
Name:NAMATH GROMME, ALLEN FREDERICK (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:FREDERICK
Last Name:NAMATH GROMME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALLEN
Other - Middle Name:FREDERICK
Other - Last Name:NAMATH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:199 1ST ST STE 310
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-2708
Practice Address - Country:US
Practice Address - Phone:650-713-0700
Practice Address - Fax:650-713-0703
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80406207RP1001X, 207RC0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine