Provider Demographics
NPI:1104206168
Name:SHARP REES-STEALY MEDICAL GROUP, INC
Entity Type:Organization
Organization Name:SHARP REES-STEALY MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-262-6666
Mailing Address - Street 1:PO BOX 939087
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-9087
Mailing Address - Country:US
Mailing Address - Phone:858-262-6344
Mailing Address - Fax:858-636-2032
Practice Address - Street 1:8010 FROST ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4284
Practice Address - Country:US
Practice Address - Phone:858-499-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHARP REES-STEALY MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-04
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW216OtherMEDICARE PTAN