Individual
DR. SANJEEV DUTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MA FRCSC
Contact information
Practice address
780 WELCH ROAD STE 206, STANFORD, CA 94305
(650) 723-6439
Mailing address
780 WELCH ROAD STE 206, STANFORD, CA 94305
(650) 723-6439
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
A88168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A881680
MEDICAL
CA
Enumeration date
10/17/2006
Last updated
07/08/2007
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