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General NPI Number Information
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NPI Number | 1528024569
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Entity Type | Individual
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Provider Name | STEPHEN R SKINNER MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 747 52ND STREET
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City | OAKLAND
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State | CA
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Zip | 94609
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Country | US
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Telephone | 510-428-3238
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Fax | 510-601-3904
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Provider Business Mailing Address
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Address Line | 747 52ND STREET
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City | OAKLAND
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State | CA
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Zip | 94609
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Country | US
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Telephone | 510-428-3238
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Fax | 510-601-3904
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G53281
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License Number State | CA
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