Healthcare Provider Details
I. General information
NPI: 1902877889
Provider Name (Legal Business Name): STEPHEN T HECHT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/30/2006
Last Update Date: 11/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2380 BECHELLI LN
REDDING CA
96002-0144
US
IV. Provider business mailing address
PO BOX 491835
REDDING CA
96049-1835
US
V. Phone/Fax
- Phone: 530-226-1800
- Fax: 530-226-1818
- Phone: 530-226-1800
- Fax: 530-226-1818
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | G45283 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | G45283 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | G45283 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | G45283 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: