Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 264173 | MA |
N | 111NI0900X | Internist | 264173 | MA |
Y | 207R00000X | Internist | A154975 | CA |
Y | 111NI0900X | Internist | A154975 | CA |
N | 207RH0000X | Hematologist | A154975 | CA |
NPI | 1265812820 |
---|---|
Provider Name | Dr. Mohana Roy |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2015 |
Last Update Date | 18/06/2021 |