Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | A100678 | CA |
NPI | 1174659841 |
---|---|
Provider Name | Keith Patrick Vanharen |
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 | 26/02/2007 |
Last Update Date | 24/06/2010 |