Provider Demographics
NPI:1740322791
Name:SIBLEY, ERIC (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:SIBLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WELCH RD STE 116
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1508
Mailing Address - Country:US
Mailing Address - Phone:650-723-5070
Mailing Address - Fax:650-498-5608
Practice Address - Street 1:750 WELCH RD STE 116
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1508
Practice Address - Country:US
Practice Address - Phone:650-723-5070
Practice Address - Fax:650-498-5608
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA499162080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG36688Medicare UPIN