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General NPI Number Information
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NPI Number | 1194900324
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Entity Type | Organization
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Legal Business Name | STELLAR MEDICAL MANAGEMENT, INC.
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 39700 BOB HOPE DR SUITE 110
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-7103
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Country | US
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Telephone | 760-340-5545
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Fax | 760-346-6208
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Provider Business Mailing Address
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Address Line | 39700 BOB HOPE DR SUITE 110
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-7103
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Country | US
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Telephone | 760-340-5545
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Fax | 760-346-6208
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | INEZ E STELLAR
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Credential |
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Telephone | 760-340-5545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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