Individual
VASU DIVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
1804 EMBARCADERO RD, STE 100, PALO ALTO, CA 94303-3341
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
4301083303
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
A121464
CA
390200000X
Student in an Organized Health Care Education/Training Program
4301083303
MI
Other
Enumeration date
03/22/2007
Last updated
04/28/2024
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