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General NPI Number Information
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NPI Number | 1235505637
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Entity Type | Organization
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Legal Business Name | ANDREA LYNN STEIN MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 08/19/2015
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Provider Practice Location Address
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Address Line | 2021 SANTA MONICA BLVD STE 730E
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City | SANTA MONICA
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State | CA
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Zip | 90404-2173
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Country | US
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Telephone | 310-453-4600
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Fax | 310-453-1426
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Provider Business Mailing Address
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Address Line | 2021 SANTA MONICA BLVD STE 730E
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City | SANTA MONICA
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State | CA
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Zip | 90404-2173
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Country | US
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Telephone | 310-453-4600
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Fax | 310-453-1426
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. ANDREA LYNN STEIN
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Credential | M.D.
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Telephone | 310-453-4600
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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 | G478010
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License Number State | IL
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