MEDICARE: EARL L. STERN M.D., INC

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
1	207W00000X	Ophthalmology Physician	A17519	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1376626010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARL L. STERN M.D., INC

Provider Business Mailing Address
First Line	:	10 MELBA AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1531
Country	:	US
Telephone Number	:	415-661-3434
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 MELBA AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1531
Country	:	US
Telephone Number	:	415-661-3434
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EARL L STERN
Credential	:	M.D.
Telephone Number	:	415-661-3434

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	01/30/2014

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