Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 134246 | CA |
N | 208000000X | Pediatrician | 134246 | CA |
N | 208000000X | Pediatrician | 51508821205 | UT |
NPI | 1073617460 |
---|---|
Provider Name | David A Stevenson |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 04/06/2015 |