Individual
MICHAEL DAVID HOLLETT
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
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
G75906
CA
2085R0202X
Diagnostic Radiology Physician
G75906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G759060
BLUE CROSS OF CA
CA
05
—
00G759060
—
CA
01
—
300121752
RAILROAD MEDICARE
CA
01
—
300121782
RAILROAD MEDICARE
CA
Enumeration date
06/15/2006
Last updated
04/09/2024
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