Provider Demographics
NPI:1194784371
Name:PORZIG, KLAUS JOACHIM (MD)
Entity type:Individual
Prefix:
First Name:KLAUS
Middle Name:JOACHIM
Last Name:PORZIG
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:STANFORD UNIVERSITY MEDICAL CENTER
Mailing Address - Street 2:300 OASTEUR DR.
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305
Mailing Address - Country:US
Mailing Address - Phone:650-723-7627
Mailing Address - Fax:
Practice Address - Street 1:STANFORD UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:300 OASTEUR DR.
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305
Practice Address - Country:US
Practice Address - Phone:650-723-7627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28344207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG283440Medicaid
CAZZZ38343ZMedicare ID - Type Unspecified
A43697Medicare UPIN
CAOOG283440Medicaid