Healthcare Provider Details

I. General information

NPI: 1497075600
Provider Name (Legal Business Name): MAURA STEFKO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 AEROVISTA PL STE 103
SAN LUIS OBISPO CA
93401-8725
US

IV. Provider business mailing address

895 AEROVISTA PL STE 103
SAN LUIS OBISPO CA
93401-8725
US

V. Phone/Fax

Practice location:
  • Phone: 805-541-3200
  • Fax: 805-541-3700
Mailing address:
  • Phone: 805-541-3200
  • Fax: 805-541-3700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA121618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: