Healthcare Provider Details

I. General information

NPI: 1366553372
Provider Name (Legal Business Name): LAURA STEVENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10070 PASADENA AVE STE 2
CUPERTINO CA
95014-5942
US

IV. Provider business mailing address

10070 PASADENA AVE STE 2
CUPERTINO CA
95014-5942
US

V. Phone/Fax

Practice location:
  • Phone: 408-746-0300
  • Fax: 408-343-1285
Mailing address:
  • Phone: 408-746-0300
  • Fax: 408-343-1285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberC37649
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: