Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | A60707 | CA |
NPI | 1114026127 |
---|---|
Provider Name | Caroline Buckway |
First Address | Stanford, CA 94305 |
Second Address | Stanford, CA 94305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 16/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G64789 | (02) | |
MD5299 | (05) | AK |