Organization
STANFORD UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GRIMM MD (PROGRAM DIRECTOR)
(650) 736-8423
Entity
Organization
Contact information
Practice address
300 PASTEUR DR, ROOM G306, STANFORD, CA 94305-2200
(650) 723-7903
Mailing address
300 PASTEUR DR, ROOM G306, STANFORD, CA 94305-2200
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
A100154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100154
MEDICAL BOARD OF CALIFORN
CA
Enumeration date
07/26/2007
Last updated
07/26/2007
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