MEDICARE: STEPHEN ENGLE M.D.

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	207R00000X	Internal Medicine Physician	G59173	CA

General Provider Information

NPI Number	:	1437500014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN ENGLE M.D.

Provider Business Mailing Address
First Line	:	14812 DICKENS ST APT 301
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-5206
Country	:	US
Telephone Number	:	818-783-7498
Fax Number	:

Provider Business Practice Location Address
First Line	:	14812 DICKENS ST APT 301
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-5206
Country	:	US
Telephone Number	:	818-783-7498
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2016
Last Update Date	:	06/25/2016

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