Organization
STANFORD HEALTH CARE
Active
Organization
STANFORD HEALTH CARE
Active
Parent organization
STANFORD HEALTH CARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
STANFORD HEALTH CARE
Authorized official
MS. FATANA AMIN-ABASSI (PROVIDER ENROLLMENT MANAGER)
(510) 974-8592
Entity
Organization
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
070000662
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000A0561
—
NM
05
—
001188115
—
NV
05
—
010207789
—
VA
05
—
034512
—
OR
05
—
050411
—
TX
05
—
092494300
—
FL
05
—
116853300
—
WY
05
—
1288115
—
NV
05
—
244848
—
HI
05
—
635477
—
AZ
05
—
7102213
—
WA
05
—
807248900
—
ID
05
—
940057626
—
CO
05
—
HS810P
—
AS
05
—
HS811P
—
AR
05
—
HSM00441H
—
CA
01
—
ZZZA4309Z
BLUE SHIELD OF CA
CA
Enumeration date
01/10/2007
Last updated
10/30/2019
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