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General NPI Number Information
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NPI Number | 1609425255
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Entity Type | Organization
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Legal Business Name | STACEY M. HEIN MD. APC
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Dates
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Enumeration Date | 09/06/2019
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Last Update Date | 09/06/2019
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Provider Practice Location Address
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Address Line | 15215 NATIONAL AVE STE 200
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City | LOS GATOS
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State | CA
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Zip | 95032-2425
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Country | US
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Telephone | 408-358-1841
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Fax | 408-356-6970
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Provider Business Mailing Address
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Address Line | 15215 NATIONAL AVE STE 200
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City | LOS GATOS
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State | CA
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Zip | 95032-2425
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Country | US
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Telephone | 408-358-1841
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Fax | 408-356-6970
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Authorized Official
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Title or Position | PROVIDER
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Name | STACEY M HEIN
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Credential | MD
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Telephone | 408-358-1841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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