Provider Demographics
NPI:1043242423
Name:STEPHEN B. FIERSTIEN, M.D.,INC.
Entity Type:Organization
Organization Name:STEPHEN B. FIERSTIEN, M.D.,INC.
Other - Org Name:BEVERLY HILLS IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:FIERSTIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-550-5858
Mailing Address - Street 1:145 S DOHENY DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2509
Mailing Address - Country:US
Mailing Address - Phone:310-550-5858
Mailing Address - Fax:310-550-5775
Practice Address - Street 1:145 S DOHENY DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2509
Practice Address - Country:US
Practice Address - Phone:310-550-5858
Practice Address - Fax:310-550-5775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G210401Medicaid
CA00G210400OtherBLUE SHIELD
CA00G210400OtherBLUE SHIELD