Mailing Instructions
Before you return the application packet, please review all of your materials thoroughly for accuracy, completeness, signatures, and dates. Please note that we cannot begin processing your application until the items listed below have been received, including all check boxes, blanks, and signatures completed.
- All professional licenses in California and other states
- DEA certificate
- X-Ray/Fluoroscopy certificate (required if you will use or supervise the use of this equipment)
- Curriculum Vitae or Resume covering your work history for the last five years
- Malpractice Insurance Certificate and names of any other insurance carriers during the last five years.
- All supporting forms (Appendix A-I)
- Application Fee of $300.00 per facility
Mail the complete packet to:
Mailing Address: (*Use this address to mail via US Postal Service)
Medical Staff
300 Pasteur Dr, MC 5288
Stanford, CA 94305
Physical Location: (*Use this address to mail via UPS or FedEx or other courier service)
Medical Staff
1510 Page Mill Rd
Palo Alto, CA 94304
