Provider Demographics
NPI:1407800659
Name:WINDOFFER, ERIC A (PA)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:A
Last Name:WINDOFFER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 UNIVERSITY AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:E PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-2285
Mailing Address - Country:US
Mailing Address - Phone:650-617-8100
Mailing Address - Fax:650-327-2947
Practice Address - Street 1:1950 UNIVERSITY AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:E PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-2285
Practice Address - Country:US
Practice Address - Phone:650-617-8100
Practice Address - Fax:650-327-2947
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14630363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S88441Medicare UPIN