Healthcare Provider Details

I. General information

NPI: 1760461719
Provider Name (Legal Business Name): DAVID ET STEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 SAMARITAN DR #1
SAN JOSE CA
95124
US

IV. Provider business mailing address

2440 SAMARITAN DR #1
SAN JOSE CA
95124
US

V. Phone/Fax

Practice location:
  • Phone: 408-626-7375
  • Fax: 408-626-7368
Mailing address:
  • Phone: 408-626-7375
  • Fax: 408-626-7368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG39186
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberG39186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: