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NPI Code Detail

MEDICARE: DR. JOSEPH GREGORY STATHOS DO

MEDICARE: DR. JOSEPH GREGORY STATHOS DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0214XPediatric Pulmonology Physician19098CA
2208000000XPediatrics Physician19098CA
3207K00000XAllergy & Immunology Physician19098CA
4390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073010799
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH GREGORY STATHOS DO
Provider Business Mailing Address
First Line : PO BOX 2246
Second Line :
City : SEAL BEACH
State : CA
Zip : 90740-1246
Country : US
Telephone Number : 562-490-9900
Fax Number :
Provider Business Practice Location Address
First Line : 701 E 28TH ST STE 419
Second Line :
City : LONG BEACH
State : CA
Zip : 90806-2775
Country : US
Telephone Number : 562-490-9900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2018
Last Update Date : 09/29/2025

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