Provider Demographics
NPI:1548676455
Name:D'ASTOUS, MYREILLE (MD)
Entity type:Individual
Prefix:
First Name:MYREILLE
Middle Name:
Last Name:D'ASTOUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 ESCUELA AVE
Mailing Address - Street 2:APT 134
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-1876
Mailing Address - Country:US
Mailing Address - Phone:650-282-0611
Mailing Address - Fax:650-723-2815
Practice Address - Street 1:300 PASTEUR DRIVE
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5327
Practice Address - Country:US
Practice Address - Phone:650-723-0230
Practice Address - Fax:650-723-2815
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132312207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery