Healthcare Provider Details

I. General information

NPI: 1467669945
Provider Name (Legal Business Name): DR. RICHARD STESS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STS COMPANY, 655 REDWOOD HWY. SUITE 203
MILL VALLEY CA
94941
US

IV. Provider business mailing address

36 DUTCH VALLEY LN
SAN ANSELMO CA
94960-1016
US

V. Phone/Fax

Practice location:
  • Phone: 415-381-4602
  • Fax:
Mailing address:
  • Phone: 415-456-7925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE1339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: