Provider Demographics
NPI:1457011736
Name:STANFORD EMPLOYER HEALTH CLINICS
Entity Type:Organization
Organization Name:STANFORD EMPLOYER HEALTH CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:GULICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-485-9551
Mailing Address - Street 1:500 PASTEUR DR
Mailing Address - Street 2:RM P388 MC5288
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1189 COLEMAN AVENUE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110
Practice Address - Country:US
Practice Address - Phone:408-412-5330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STANFORD HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care