Provider Demographics
NPI:1376787077
Name:GAUDILLIERE, BRICE LOUIS JULES (MD, PHD)
Entity Type:Individual
Prefix:
First Name:BRICE
Middle Name:LOUIS JULES
Last Name:GAUDILLIERE
Suffix:
Gender:M
Credentials:MD, PHD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1560 SAND HILL RD
Mailing Address - Street 2:306
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2062
Mailing Address - Country:US
Mailing Address - Phone:617-230-5927
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA113580207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology