Healthcare Provider Details

I. General information

NPI: 1427134832
Provider Name (Legal Business Name): SIMA STEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 11/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N BASCOM AVE #102
SAN JOSE CA
95128
US

IV. Provider business mailing address

105 N BASCOM AVE #102
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-292-0100
  • Fax: 408-292-0431
Mailing address:
  • Phone: 408-292-0100
  • Fax: 408-292-0431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA55498
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: