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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