Healthcare Provider Details

I. General information

NPI: 1285626374
Provider Name (Legal Business Name): STEPHEN N FINBERG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date: 03/23/2006
Reactivation Date: 03/29/2006

III. Provider practice location address

6970 E CHAUNCEY LN STE 100
PHOENIX AZ
85054-5158
US

IV. Provider business mailing address

6970 E CHAUNCEY LN STE 100
PHOENIX AZ
85054-5158
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-7211
  • Fax: 602-788-1890
Mailing address:
  • Phone: 602-788-7211
  • Fax: 602-788-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number1549
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number1549
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: