Healthcare Provider Details

I. General information

NPI: 1912494188
Provider Name (Legal Business Name): STEFANIE ALTMANN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PRINGLE AVE STE 425
WALNUT CREEK CA
94596-7385
US

IV. Provider business mailing address

4000 HOLLYWOOD BLVD STE 215-A
HOLLYWOOD FL
33021-6751
US

V. Phone/Fax

Practice location:
  • Phone: 925-932-3800
  • Fax: 925-933-3339
Mailing address:
  • Phone: 954-988-0976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberOS18824
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberUO6375
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberOS18824
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number24681
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberPG188434
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: