Provider Demographics
NPI:1093781072
Name:STEPKE, BERNHARD KARL (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNHARD
Middle Name:KARL
Last Name:STEPKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7018 BLAIR RD
Mailing Address - Street 2:MEDICAL DEPARTMENT, CALIPATRIA STATE PRISON
Mailing Address - City:CALIPATRIA
Mailing Address - State:CA
Mailing Address - Zip Code:92233
Mailing Address - Country:US
Mailing Address - Phone:760-348-7000
Mailing Address - Fax:
Practice Address - Street 1:7018 BLAIR RD
Practice Address - Street 2:MEDICAL DEPARTMENT, CALIPATRIA STATE PRISON
Practice Address - City:CALIPATRIA
Practice Address - State:CA
Practice Address - Zip Code:92233
Practice Address - Country:US
Practice Address - Phone:760-348-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200301180207Q00000X
KS04-33799207Q00000X
CAA96562207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine