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General NPI Number Information
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NPI Number | 1730145699
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Entity Type | Organization
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Legal Business Name | THOMAS K. STERN, M.D. P.C.
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 3000 COLBY STREET SUITE 110
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City | BERKELEY
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State | CA
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Zip | 94705-0000
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Country | US
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Telephone | 510-649-1249
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Fax | 510-649-1345
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Provider Business Mailing Address
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Address Line | 3000 COLBY STREET SUITE 110
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City | BERKELEY
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State | CA
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Zip | 94705-0000
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Country | US
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Telephone | 510-649-1249
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Fax | 510-649-1345
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS K. STERN
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Credential | M.D.
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Telephone | 510-649-1249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G25191
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License Number State | CA
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