Provider Demographics
NPI:1962712505
Name:STANFORD BLOOD CENTER, LLC
Entity type:Organization
Organization Name:STANFORD BLOOD CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HARPRIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-723-7994
Mailing Address - Street 1:3373 HILLVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1204
Mailing Address - Country:US
Mailing Address - Phone:650-723-7994
Mailing Address - Fax:650-725-4470
Practice Address - Street 1:3373 HILLVIEW AVE
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304
Practice Address - Country:US
Practice Address - Phone:650-723-7994
Practice Address - Fax:650-725-4470
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STANFORD HEALTH CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-18
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9796331L00000X
CAID9195331L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank
Provider Identifiers
StateIdentifier IDID TypeIssuer
FEI 2970004OtherFDA REGISTRATION NUMBER
CA9796OtherLICENSE FOR THE PRODUCTION OF BIOLOGICS