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General NPI Number Information
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NPI Number | 1871907105
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Entity Type | Individual
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Provider Name | STEPHEN E. WHITE P.A.-C.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2014
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 22 CORPORATE PLAZA DR
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City | NEWPORT BEACH
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State | CA
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Zip | 92660
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Country | US
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Telephone | 949-722-5017
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Fax | 949-432-3354
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Provider Business Mailing Address
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Address Line | 1975 SHERINGTON PL APT H112
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-6090
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Country | US
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Telephone | 401-523-3545
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110004697
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA031038
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0005385
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C05385
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 53342
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License Number State | CA
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