# STANFORD UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518490291
- **Authorized official:** MARCY KULAKOW (REGISTRAR STANFORD GME)
- **Authorized official phone:** (650) 723-5948

## Contact information

- **Practice address:** 401 QUARRY RD, STANFORD, CA 94305
- **Practice address phone:** (847) 644-0786
- **Mailing address:** 2515 KEMPER RD, APT 510, SHAKER HEIGHTS, OH 44120-5500
- **Mailing address phone:** (847) 644-0786

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/10/2017
- **Last updated:** 04/10/2017