Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | C175079 | CA |
Y | 208600000X | Surgeon | C175079 | CA |
N | 2086S0102X | Surgical Critical Care | 036.144069 | IL |
N | 2086S0102X | Surgical Critical Care | C175079 | CA |
N | 2086S0127X | Trauma Surgeon | 036.144069 | IL |
NPI | 1235304551 |
---|---|
Provider Name | Dr. Peter Gerard Bendix |
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 | 28/04/2008 |
Last Update Date | 01/11/2021 |