Sanjeev Dutta, MD MA FRCSC

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

A88168 Issued in CA

Practice address

780 Welch Road Ste 206
Stanford, CA 94305

Phone

(650) 723-6439

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  NPD (past)
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659452720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 WELCH ROAD STE 206",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-723-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 WELCH ROAD STE 206",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "94305",
            "telephone_number": "650-723-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTA",
        "first_name": "SANJEEV",
        "name_prefix": "Dr.",
        "credential": "MD MA FRCSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "A88168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "00A881680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin J Durant, MD
• Eileen Durham, NP
• Maxwell Stuart Durtschi
• Alex Maurice Dussaq, MD, PHD
• Angela Rose Dutremaine, PA-C
• Jaime Nicole Dutton, MD
• Madhavi Vijaya Venkata Surya Duvvuri, MD
• Margaret Ellen Dvorak, LCSW
• Sean Michael Dy Juanco, PA-C
• Peter Culik Dy

• Pediatric Surgery Physician in Stanford, CA
• Providers in Stanford, CA by specialty
• Pediatric Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.