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General NPI Number Information
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NPI Number | 1225242688
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Entity Type | Organization
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Legal Business Name | STEPHEN B. PREPAS, M.D., A MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 360 SAN MIGUEL DR SUITE 407
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7822
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Country | US
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Telephone | 949-644-7026
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Fax | 949-644-7029
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Provider Business Mailing Address
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Address Line | 360 SAN MIGUEL DRIVE SUITE 407
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7822
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Country | US
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Telephone | 949-644-7026
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Fax | 949-644-7029
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. STEPHEN B. PREPAS
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Credential | M.D.
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Telephone | 949-644-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G32851
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License Number State | CA
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