Healthcare Provider Details

I. General information

NPI: 1831118371
Provider Name (Legal Business Name): THOMAS E STILES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 ADAMS ST 201
SAINT HELENA CA
94574-1148
US

IV. Provider business mailing address

999 ADAMS ST 201
SAINT HELENA CA
94574-1148
US

V. Phone/Fax

Practice location:
  • Phone: 707-255-8825
  • Fax: 707-252-9325
Mailing address:
  • Phone: 707-255-8825
  • Fax: 707-252-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberG22053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: