Provider Demographics
NPI:1427314855
Name:AHMED, FAISAL (MD)
Entity type:Individual
Prefix:DR
First Name:FAISAL
Middle Name:
Last Name:AHMED
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 1:875 BLAKE WILBUR DRIVE, RM 305
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-0000
Mailing Address - Country:US
Mailing Address - Phone:650-723-6171
Mailing Address - Fax:
Practice Address - Street 1:STANFORD MEDICAL CENTER, DEPT. OF RADIATION ONCOLOGY
Practice Address - Street 2:875 BLAKE WILBUR DR RM 305
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-0000
Practice Address - Country:US
Practice Address - Phone:650-723-6171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1374012085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology