Healthcare Provider Details

I. General information

NPI: 1730145699
Provider Name (Legal Business Name): THOMAS K. STERN, M.D. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 COLBY STREET SUITE 110
BERKELEY CA
94705-0000
US

IV. Provider business mailing address

3000 COLBY STREET SUITE 110
BERKELEY CA
94705-0000
US

V. Phone/Fax

Practice location:
  • Phone: 510-649-1249
  • Fax: 510-649-1345
Mailing address:
  • Phone: 510-649-1249
  • Fax: 510-649-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG25191
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS K. STERN
Title or Position: OWNER
Credential: M.D.
Phone: 510-649-1249