Organization
DR ALA STANFORD CENTER FOR HEALTH EQUITY
Active
Other names
ALA STANFORD MD SOLE MBR
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA ANTOINETTE TAYLOR (DIRECTOR OF OPERATIONS)
(267) 501-1627
Entity
Organization
Contact information
Practice address
2001 W LEHIGH AVE, PHILADELPHIA, PA 19132-2652
(844) 423-2362
(215) 654-3063
Mailing address
2001 W LEHIGH AVE, PHILADELPHIA, PA 19132-2652
(267) 501-1627
(484) 443-6296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041122130001
—
PA
Enumeration date
11/12/2021
Last updated
09/05/2025
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