Individual
DR. MANOJ CHALAKUZHY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(713) 500-7640
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
7548
GA
2085R0202X
Diagnostic Radiology Physician
650923
TX
2085R0202X
Diagnostic Radiology Physician
Primary
A167826
CA
Other
Enumeration date
06/24/2015
Last updated
07/08/2020
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