Healthcare Provider Details

I. General information

NPI: 1982675021
Provider Name (Legal Business Name): STEPHEN W DOGGETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20341 SW BIRCH ST STE 330
NEWPORT BEACH CA
92660-1515
US

IV. Provider business mailing address

PO BOX 2901
NEWPORT BEACH CA
92659-0375
US

V. Phone/Fax

Practice location:
  • Phone: 949-490-4820
  • Fax: 949-490-4819
Mailing address:
  • Phone: 714-573-9500
  • Fax: 714-573-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number18643
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberAZ47460
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD 00031750
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number47460
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG49856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: