Individual
KELLY B. MAHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR RM 211, STANFORD, CA 94305-2200
(650) 497-8775
Mailing address
300 PASTEUR DR RM 211, STANFORD, CA 94305-2200
(650) 497-8775
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
0101258492
VA
207T00000X
Neurological Surgery Physician
41124
IA
207T00000X
Neurological Surgery Physician
Primary
A149898
CA
207T00000X
Neurological Surgery Physician
R8192
IA
Other
Enumeration date
07/05/2007
Last updated
11/20/2017
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