Individual
DR. JAIME SOU ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
269 CAMPUS DR, CCSR 3215, MC 5366, STANFORD, CA 94305-5101
(650) 498-6073
(650) 498-5560
Mailing address
269 CAMPUS DR, CCSR 3215, MC 5366, STANFORD, CA 94305-5101
(650) 498-6073
(650) 498-5560
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
A 121193
CA
208000000X
Pediatrics Physician
Primary
A 121193
CA
Other
Enumeration date
07/09/2012
Last updated
11/25/2013
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