Individual provider · NPI-1

Vetzrel Adidala, PA-C

Physician Assistant · Stanford, CA

NPI number1134964372
StatusActive
Last updated in NPPESNov 11, 2024

Details

NPI
1134964372
Entity type
Individual (NPI-1)
Name
Vetzrel Adidala
Credential
PA-C
Sole proprietor
Yes
Enumeration date
Jun 28, 2024
Certification date
Nov 11, 2024
Last updated
Nov 11, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant64851CAYes

Practice location

300 Pasteur Dr
Stanford, CA 94305-2200

Phone 650-723-4000

Mailing address

300 Pasteur Dr
Stanford, CA 94305-2200

Phone 650-723-4000

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