Healthcare Provider Details

I. General information

NPI: 1942317342
Provider Name (Legal Business Name): JAMES H.STERNBERG, M.D. A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 WILSHIRE BLVD SUITE 410
LOS ANGELES CA
90024-3987
US

IV. Provider business mailing address

10921 WILSHIRE BLVD SUITE #410
LOS ANGELES CA
90024-3987
US

V. Phone/Fax

Practice location:
  • Phone: 310-208-8688
  • Fax: 310-208-0959
Mailing address:
  • Phone: 310-208-8688
  • Fax: 310-208-0959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG20738
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberG20738
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberG20738
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES H STERNBERG
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 310-208-8688