Basic Information
Provider Information
NPI: 1487896239
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: O'MALLEY
FirstName: KATHARINE
MiddleName: NEWMAN
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: NEWMAN
OtherFirstName: KATHARINE
OtherMiddleName: B
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 300 PASTEUR DR
Address2: RM G302
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507258623
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DR
Address2: RM G302
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507258623
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/25/2009
LastUpdateDate: 01/10/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207V00000XA125125CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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