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General NPI Number Information
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NPI Number | 1356451488
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Entity Type | Individual
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Provider Name | STEPHEN J CARNEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 1860 EL CAMINO REAL STE 236
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City | BURLINGAME
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State | CA
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Zip | 94010-3111
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Country | US
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Telephone | 650-651-7112
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Fax | 650-689-5271
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Provider Business Mailing Address
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Address Line | 1860 EL CAMINO REAL STE 236
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City | BURLINGAME
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State | CA
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Zip | 94010-3111
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Country | US
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Telephone | 650-651-7112
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Fax | 650-689-5271
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G61092
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License Number State | CA
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