Healthcare Provider Details

I. General information

NPI: 1104206168
Provider Name (Legal Business Name): SHARP REES-STEALY MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 FROST ST FL 2
SAN DIEGO CA
92123-4284
US

IV. Provider business mailing address

PO BOX 939087
SAN DIEGO CA
92193-9087
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2600
  • Fax:
Mailing address:
  • Phone: 858-262-6344
  • Fax: 858-636-2032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN J BIER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 858-262-6666