Individual
STEVEN RICHARD SANISLO
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
2452 WATSON COURT, PALO ALTO, CA 94303
(650) 323-0231
(650) 323-6385
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
G74925
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
G74925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G749250
—
CA
Enumeration date
12/05/2006
Last updated
04/04/2024
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