Organization
LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY CARMACK (CHIEF FINANCIAL OFFICER)
(650) 736-0031
Entity
Organization
Contact information
Practice address
725 WELCH RD, MAIL CODE 5500, PALO ALTO, CA 94304-1601
(650) 497-8565
Mailing address
725 WELCH RD, MAIL CODE 5500, PALO ALTO, CA 94304-1601
(650) 497-8357
(650) 493-2491
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
282NC2000X
Children's Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0 1241116
—
KY
05
—
0 410737
—
MT
05
—
00 1189126
—
NV
05
—
002182000
—
ID
05
—
00977963X
—
GA
05
—
100105870A
—
KS
05
—
1700479
—
LA
05
—
355075
—
AZ
05
—
54281201
—
HI
05
—
912214100
—
FL
05
—
95018255
—
CO
05
—
A5935
—
NM
05
—
HS966
—
AK
05
—
HSC11103G
—
CA
05
—
HSP41103G
—
CA
05
—
LUC3305N
—
AL
05
—
ZZR11103G
—
CA
01
—
ZZZB4301Z
BLUE SHIELD
CA
Enumeration date
10/26/2005
Last updated
12/24/2024
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