Individual
JAN BOUBLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
788 8TH AVE APT 4, SAN FRANCISCO, CA 94118-3790
(917) 617-6261
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C139846
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232132
MASSACHUSETTS MEDICAL BOA
—
01
—
256914
NY OFFICE OF THE PROFESSIONS
NY
Enumeration date
07/26/2007
Last updated
04/08/2024
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