Healthcare Provider Details

I. General information

NPI: 1306058565
Provider Name (Legal Business Name): STEWART AND STEWART A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 S GARFIELD AVE
ALHAMBRA CA
91801-4762
US

IV. Provider business mailing address

1024 S GARFIELD AVE
ALHAMBRA CA
91801-4762
US

V. Phone/Fax

Practice location:
  • Phone: 626-289-5181
  • Fax:
Mailing address:
  • Phone: 626-289-5181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN THOMAS STEWART
Title or Position: OWNER VICE PRESIDENT
Credential: M.D.
Phone: 626-289-5181