Healthcare Provider Details

I. General information

NPI: 1225033764
Provider Name (Legal Business Name): FRANK J. STELLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 05/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 CENTER DR STE 505
LA MESA CA
91942-3017
US

IV. Provider business mailing address

9610 GRANITE RIDGE DR STE B
SAN DIEGO CA
92123-2684
US

V. Phone/Fax

Practice location:
  • Phone: 619-461-3880
  • Fax: 619-461-3895
Mailing address:
  • Phone: 858-499-1900
  • Fax: 858-268-1911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberG19078
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: