Provider Demographics
NPI:1134471071
Name:STONE MOUNTAIN MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:STONE MOUNTAIN MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:STEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-473-8253
Mailing Address - Street 1:3608 NAPA CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5461
Mailing Address - Country:US
Mailing Address - Phone:760-473-8253
Mailing Address - Fax:
Practice Address - Street 1:3608 NAPA CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5461
Practice Address - Country:US
Practice Address - Phone:760-473-8253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes209800000XAllopathic & Osteopathic PhysiciansLegal MedicineGroup - Single Specialty