Provider Demographics
NPI:1154479624
Name:PICKEL, STUART MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:MICHAEL
Last Name:PICKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:909 HYDE STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4846
Mailing Address - Country:US
Mailing Address - Phone:415-385-3367
Mailing Address - Fax:415-383-3649
Practice Address - Street 1:909 HYDE STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4846
Practice Address - Country:US
Practice Address - Phone:415-385-3367
Practice Address - Fax:415-383-3649
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC324052084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F05314Medicare UPIN