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NPI Code Detail

MEDICARE: KARL S STUTELBERG MSPT

MEDICARE: KARL S STUTELBERG MSPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT 33857CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WPT33857AOTHERCAMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255385746
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARL S STUTELBERG MSPT
Provider Business Mailing Address
First Line : 335 E AVENUE I
Second Line :
City : LANCASTER
State : CA
Zip : 93535-1916
Country : US
Telephone Number : 661-471-4080
Fax Number : 661-524-2964
Provider Business Practice Location Address
First Line : 335 E AVENUE I
Second Line :
City : LANCASTER
State : CA
Zip : 93535-1916
Country : US
Telephone Number : 661-471-4080
Fax Number : 661-524-2964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 02/11/2020

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