Provider Demographics
NPI:1497046130
Name:STANFORD HOSPITAL & CLINICS
Entity Type:Organization
Organization Name:STANFORD HOSPITAL & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEMIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYOUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-723-2188
Mailing Address - Street 1:300 PASTEUR DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1510 PAGE MILL RD
Practice Address - Street 2:M137
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1125
Practice Address - Country:US
Practice Address - Phone:650-723-2188
Practice Address - Fax:650-644-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital