Individual
PRACHAYA NITICHAIKULVATANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
207R00000X
Internal Medicine Physician
C175548
CA
207RR0500X
Rheumatology Physician
Primary
C175548
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3081927
—
NH
Enumeration date
05/31/2007
Last updated
04/15/2024
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