1124386305 NPI number — MISS CHRISTINA STACHUR M.D.

Table of content: MISS CHRISTINA STACHUR M.D. (NPI 1124386305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124386305 NPI number — MISS CHRISTINA STACHUR M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STACHUR
Provider First Name:
CHRISTINA
Provider Middle Name:
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124386305
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 PASTEUR DRIVE
Provider Second Line Business Mailing Address:
GRANT S101
Provider Business Mailing Address City Name:
STANFORD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94305
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-723-6661
Provider Business Mailing Address Fax Number:
650-498-6205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 PASTEUR DRIVE
Provider Second Line Business Practice Location Address:
GRANT S101
Provider Business Practice Location Address City Name:
STANFORD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-723-6661
Provider Business Practice Location Address Fax Number:
650-498-6205
Provider Enumeration Date:
04/25/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)