Healthcare Provider Details

I. General information

NPI: 1184694762
Provider Name (Legal Business Name): STUART C STEINBERG D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 W MAGNOLIA BLVD
BURBANK CA
91505-2907
US

IV. Provider business mailing address

11273 DONA LISA DR
STUDIO CITY CA
91604-4314
US

V. Phone/Fax

Practice location:
  • Phone: 818-848-5586
  • Fax: 818-848-2067
Mailing address:
  • Phone: 323-650-8947
  • Fax: 323-656-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2586
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE2586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: