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General NPI Number Information
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NPI Number | 1437285269
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Entity Type | Organization
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Legal Business Name | STEFAN UNTERHALTER MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/31/2016
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Provider Practice Location Address
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Address Line | 9001 WILSHIRE BLVD SUITE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1838
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Country | US
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Telephone | 310-274-2722
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Fax | 310-275-1082
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Provider Business Mailing Address
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Address Line | 9001 WILSHIRE BLVD SUITE 201
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1838
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Country | US
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Telephone | 310-274-2722
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Fax | 310-275-1082
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEFAN ANDREW UNTERHALTER
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Credential | M.D.
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Telephone | 310-274-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A33152
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License Number State | CA
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