Provider Demographics
NPI:1013356336
Name:STERBUTZEL, PETER EHREN (DO)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:EHREN
Last Name:STERBUTZEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4240 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-2764
Practice Address - Country:US
Practice Address - Phone:909-864-4700
Practice Address - Fax:909-864-4300
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY274346-216207V00000X
CA20A15614207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology