Individual
DEBRA MASAKO IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
2085R0202X
Diagnostic Radiology Physician
Primary
G59883
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G598830
—
CA
Enumeration date
02/06/2007
Last updated
04/09/2024
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