Provider Demographics
NPI:1164795068
Name:DERRINGTON, STEPHEN (DO, INC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:DERRINGTON
Suffix:
Gender:M
Credentials:DO, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 VISTA WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3628
Mailing Address - Country:US
Mailing Address - Phone:760-721-4000
Mailing Address - Fax:760-721-4005
Practice Address - Street 1:3142 VISTA WAY STE 206
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3628
Practice Address - Country:US
Practice Address - Phone:707-255-5454
Practice Address - Fax:707-255-5411
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2698208100000X
CA20A14038208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation