Provider Demographics
NPI:1093790446
Name:CENTER, STEPHEN ALAN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ALAN
Last Name:CENTER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:2878 CAMINO DEL RIO S STE 404
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3848
Mailing Address - Country:US
Mailing Address - Phone:619-419-2655
Mailing Address - Fax:619-955-8575
Practice Address - Street 1:2878 CAMINO DEL RIO S STE 404
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-419-2655
Practice Address - Fax:619-955-8575
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-08
Last Update Date:2018-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG37305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine