Individual
CARLOS IVAN ENCISO LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-5948
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301512806
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A203750
CA
Other
Enumeration date
06/03/2021
Last updated
07/29/2026
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