Individual
DEREK FAKHREDEAN AMANATULLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
450 BROADWAY ST, MC 6342, PAVILION C, 4TH FLOOR, REDWOOD CITY, CA 94063-3132
(650) 723-2257
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
106870
MN
207X00000X
Orthopaedic Surgery Physician
56793
MN
207X00000X
Orthopaedic Surgery Physician
A105899
CA
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
A105899
CA
Other
Enumeration date
05/22/2008
Last updated
04/23/2024
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