=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447258389
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREA STEBEL M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2005
-----------------------------------------------------
Last Update Date | 01/31/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 SUPERIOR AVE STE 280
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92663-6140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-877-9518
-----------------------------------------------------
Fax | 949-577-4816
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 SUPERIOR AVE STE 280
-----------------------------------------------------
City | NEWPORT BEACH
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92663-6140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-877-9518
-----------------------------------------------------
Fax | 949-577-4816
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | A41693
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------