Provider Demographics
NPI:1861400657
Name:STANFORD, DONALD H (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:H
Last Name:STANFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2232 CARLETON ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-3225
Mailing Address - Country:US
Mailing Address - Phone:510-540-6235
Mailing Address - Fax:510-841-8025
Practice Address - Street 1:2232 CARLETON ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-3225
Practice Address - Country:US
Practice Address - Phone:510-540-6235
Practice Address - Fax:510-841-8025
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG197322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry