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General NPI Number Information
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NPI Number | 1558504241
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Entity Type | Organization
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Legal Business Name | STEVEN D STOCKARD DPM A PROFESSION L PODIATRIC CORP
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Dates
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Enumeration Date | 04/11/2009
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 17401 NICHOLS LN SUITE E
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5777
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Country | US
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Telephone | 562-761-4388
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Fax | 714-908-1970
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Provider Business Mailing Address
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Address Line | 17401 NICHOLS LN SUITE E
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-5777
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Country | US
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Telephone | 562-761-4388
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Fax | 714-908-1970
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEVEN D STOCKARD
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Credential | DPM
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Telephone | 714-892-0992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E4255
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License Number State | CA
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