MEDICARE: SHARP REES-STEALY MEDICAL GROUP, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207V00000X	Obstetrics & Gynecology Physician
3	207W00000X	Ophthalmology Physician
4	207X00000X	Orthopaedic Surgery Physician
5	207Y00000X	Otolaryngology Physician
6	208000000X	Pediatrics Physician
7	208600000X	Surgery Physician
8	208800000X	Urology Physician
9	213E00000X	Podiatrist
10	363A00000X	Physician Assistant
11	207P00000X	Emergency Medicine Physician
12	152W00000X	Optometrist
13	207N00000X	Dermatology Physician
14	363L00000X	Nurse Practitioner
15	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285616177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARP REES-STEALY MEDICAL GROUP, INC

Provider Business Mailing Address
First Line	:	5651 COPLEY DR STE A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-7903
Country	:	US
Telephone Number	:	858-262-6666
Fax Number	:	619-696-1579

Provider Business Practice Location Address
First Line	:	5651 COPLEY DR STE A
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-7903
Country	:	US
Telephone Number	:	858-262-6666
Fax Number	:	858-262-6777

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALAN J BIER III
Credential	:	M.D.
Telephone Number	:	858-262-6666

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	09/27/2022

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