Provider Demographics
NPI:1538356969
Name:ACKLAND, GARETH LEWIS (PHD FRCA)
Entity type:Individual
Prefix:
First Name:GARETH
Middle Name:LEWIS
Last Name:ACKLAND
Suffix:
Gender:M
Credentials:PHD FRCA
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Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR # H3580
Mailing Address - Street 2:STANFORD HOSPITAL ANESETHESIA DEPT
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-723-6412
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR # H3580
Practice Address - Street 2:STANFORD HOSPITAL ANESETHESIA DEPT
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2113-F5428207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology