Provider Demographics
NPI:1861588030
Name:ABAD, VIVIEN (MD)
Entity type:Individual
Prefix:
First Name:VIVIEN
Middle Name:
Last Name:ABAD
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:PO BOX 3006
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-0006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2690 HANOVER STREET
Practice Address - Street 2:STANFORD HOSPITAL AND CLINICS
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1117
Practice Address - Country:US
Practice Address - Phone:650-721-7557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA368922084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA28211Medicare UPIN