Provider Demographics
NPI:1760508899
Name:KIDD, ELIZABETH A (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:KIDD
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Gender:F
Credentials:MD
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Mailing Address - Street 1:875 BLAKE WILBUR DR.
Mailing Address - Street 2:STANFORD CANCER CENTER, MAIL CODE 5847
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5847
Mailing Address - Country:US
Mailing Address - Phone:650-723-6171
Mailing Address - Fax:650-725-8231
Practice Address - Street 1:875 BLAKE WILBUR DR.
Practice Address - Street 2:STANFORD CANCER CENTER, MAIL CODE 5847
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5847
Practice Address - Country:US
Practice Address - Phone:650-723-6171
Practice Address - Fax:650-725-8231
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2014-02-15
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Provider Licenses
StateLicense IDTaxonomies
CAA1125242085R0203X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology