Individual
IRA GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 498-5710
Mailing address
2680 HANOVER ST, PALO ALTO, CA 94304-1117
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G9084
CA
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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