DR. SAMUEL KAI SUM SO (NPI# 1982730065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982730065 |
| Entity Type | Individual |
| Full Name | DR. SAMUEL KAI SUM SO |
| Credential | M.D., F.A.C.S. |
| Practice Address |
875 Blake Wilbur Drive Clinic B Stanford CA 94305-5820 |
| Mailing Address |
300 Pasteur Dr H3680 Stanford CA 94305-2200 |
| Practice Telephone | 6507235461 |
| Mailing Telephone | 6507235972 |
| Mailing Fax Number | 6507230006 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
A51497 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A514970 | 05 |
| Street Address |
875 BLAKE WILBUR DRIVE CLINIC B |
| City | STANFORD |
| State | CA |
| Zip Code | 94305-5820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932135290 | Melinda L Telli | Internal Medicine | 875 Blake Wilbur Drive, Mc 5820, Stanford, CA 94305 | 2006-06-25 |
| 1659829059 | Michelle S. Gonzales | Nurse Practitioner | 875 Blake Wilbur Drive, Cc-1314, Stanford, CA 94305 | 2016-09-14 |
| 1831569391 | Misty Mahaffey | Nurse Practitioner | 875 Blake Wilbur Drive, Stanford, CA 94305 | 2015-09-28 |
| 1104200575 | Vinay Thomas Fernandes | Otolaryngology | 875 Blake Wilbur Drive, Cc-2226a, Stanford, CA 94305 | 2015-07-16 |
| 1780006916 | Gregory Smith Moran | Nurse Practitioner | 875 Blake Wilbur Drive, Clinic E, Stanford, CA 94305 | 2014-01-07 |
| 1407193386 | Jessie Denise Coty | Nurse Practitioner | 875 Blake Wilbur Drive, Stanford, CA 94305-5820 | 2013-01-11 |
| 1043589880 | Sara Aileen Dudley | Student in an Organized Health Care Education/Training Program | 875 Blake Wilbur Drive, Cc-g222, Stanford, CA 94305-5847 | 2011-12-23 |
| 1568766442 | Siok-hian Tay-kelley | Nurse Practitioner | 875 Blake Wilbur Drive, Gastrointestinal Oncology Stanford Cancer Center, Stanford, CA 94305-2205 | 2011-01-06 |
| 1083918445 | Maricris Bertolano Dacumos | Nurse Practitioner | 875 Blake Wilbur Drive, Stanford, CA 94305 | 2010-12-28 |
| 1164737318 | Scott Victor Bratman | Radiology | 875 Blake Wilbur Drive, Stanford Cancer Center, Stanford, CA 94305-5847 | 2010-08-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760092126 | Meilin Liang | Physician Assistant | 300 Pasteur Rd, Rm H0101, Stanford, CA 94305 | 2020-07-31 |
| 1356962484 | Shuo Cai | Student in an Organized Health Care Education/Training Program | 300 Pasteur Drive Stanford University School of Medici, Lane Building, Stanford, CA 94305 | 2020-04-29 |
| 1760046916 | Jennifer M Piselli | Physician Assistant | 300 Pasteur Drive Rm A345, 3rd Floor, Stanford, CA 94305 | 2019-04-23 |
| 1912482365 | Martin Nikolaus Stienen | Neurological Surgery | Department of Neurosurgery,stanford University Hospital, 300 Pasteur Drive, Edwards Bldg., Rm R209, Stanford, CA 94305 | 2018-10-02 |
| 1043797434 | Natalie Lynn Dykzeul | Genetic Counselor, MS | 300 Pasteur Drive H315, Stanford, CA 94305 | 2018-07-27 |
| 1144727223 | Kingsley Anuoluwapo Oladeji | Student in an Organized Health Care Education/Training Program | Stanford Health Care Dept. of Gme, 300 Pasteur Drive, Palo Alto, CA 94305 | 2018-04-06 |
| 1437675402 | Abhinav Sharma | Internal Medicine | 300 Pasteur Lane, Falk Building, Palo Alto, CA 94305 | 2017-08-21 |
| 1194258491 | Silvia Paola Russo | Student in an Organized Health Care Education/Training Program | 300 Pasteur Dr # H3144, Palo Alto, CA 94305 | 2017-04-04 |
| 1649629155 | Jason Ross | Student in an Organized Health Care Education/Training Program | Stanford University School of Medicine Stanford Cancer, 875 Blake Wilbur Drive, Stanford, CA 94305 | 2016-06-06 |
| 1588010235 | Brian Dang | Pharmacist | 500 Pasteur Drive Room J010, Stanford, CA 94305 | 2016-05-12 |
| Find all providers in zip 94305 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104951508 | Irene Wapnir | Surgery | 300 Pasteur Dr, H3625, Stanford, CA 94305-2200 | 2007-02-23 |
| 1003941493 | Ralph Steven Greco | Surgery | 300 Pasteur Dr, H3691, Stanford, CA 94305-2200 | 2007-02-23 |
| 1255471371 | Jeffrey A Norton | Surgery | 300 Pasteur Dr, Dept. of Surgery, Room H3591, Stanford, CA 94305-2200 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801418702 | Farzad Alemi Md Inc | Surgery | 3628 E Imperial Hwy Ste 103, Lynwood, CA 90262-2600 | 2020-05-13 |
| 1699232801 | Megan Gregor | Surgery | One Hoag Dr., Bldg 41, Ste 122, Newport Beach, CA 92663 | 2019-02-24 |
| 1225511835 | Brendan Boland Md Inc | Surgery | 9001 Wilshire Blvd Ste 207, Beverly Hills, CA 90211-1843 | 2018-09-10 |
| 1508377409 | Curetology Surgical Oncology Medical Corporation & Associates | Surgery | 1127 Wilshire Blvd Ste 1604, Los Angeles, CA 90017-4007 | 2017-10-18 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1336572734 | Lana D Louie | Surgery | 18370 Burbank, Suite 607, Tarzana, CA 91356-2833 | 2013-08-21 |
| 1942544515 | Leland J Foshag, Md Inc | Surgery | 11818 Wilshire Blvd Ste 200, Los Angeles, CA 90025-6647 | 2012-11-20 |
| 1447516935 | Fank B Callipari X | Surgery | 14914 Huntington Gate Dr, Poway, CA 92064-6709 | 2012-04-09 |
| 1649549767 | Joseph Dotan | Surgery | 1618 Woodlands Rd, Beaumont, CA 92223-8569 | 2011-12-19 |
| 1679801609 | Carl Mason Sutherland II | Surgery | 539 28th Ave, San Mateo, CA 94403-2601 | 2009-12-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.