MEDICARE: AUERBACH, STEPHEN M MD, 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	174400000X	Specialist

General Provider Information

NPI Number	:	1518152537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUERBACH, STEPHEN M MD, INC

Provider Business Mailing Address
First Line	:	400 NEWPORT CENTER DR STE 501
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7606
Country	:	US
Telephone Number	:	949-644-7200
Fax Number	:	949-644-7937

Provider Business Practice Location Address
First Line	:	400 NEWPORT CENTER DR STE 501
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7606
Country	:	US
Telephone Number	:	949-644-7200
Fax Number	:	949-644-7937

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN MICHAEL AUERBACH
Credential	:	M.D.
Telephone Number	:	949-644-7200

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	09/12/2007

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