Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 224807 | MA |
N | 207VX0201X | Gynecologic Oncologist | 25MA8279400 | NJ |
N | 207VX0201X | Gynecologic Oncologist | 54011 | CT |
Y | 207VX0201X | Gynecologic Oncologist | C160189 | CA |
NPI | 1003877002 |
---|---|
Provider Name | Dr. Babak Litkouhi |
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 | 29/03/2006 |
Last Update Date | 29/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0138321 | (05) | NJ |