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General NPI Number Information
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NPI Number | 1659687861
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Entity Type | Organization
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Legal Business Name | JAY J STEIN MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 8635 W 3RD ST SUITE #460W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-652-8810
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Fax | 310-652-0334
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Provider Business Mailing Address
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Address Line | 8635 W 3RD ST SUITE #460W
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City | LOS ANGELES
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State | CA
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Zip | 90048-6101
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Country | US
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Telephone | 310-652-8810
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Fax | 310-652-0334
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JAY JOSEPH STEIN
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Credential | M.D.
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Telephone | 310-652-8810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | C32471
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License Number State | CA
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