Provider Demographics
NPI:1225075518
Name:STELMAN, MICHAEL ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:STELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 WEYMOUTH LN
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-4049
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1355 WEYMOUTH LN
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-4049
Practice Address - Country:US
Practice Address - Phone:805-232-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70001207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-1683892OtherOTHER INSURANCE
CA050394OtherBLUE CROSS
CARHM18553HMedicaid
CARHM08609FMedicaid
CARHM08608FMedicaid
CAZZT40394FMedicaid
CARHM08609FMedicaid
F41078Medicare UPIN
CAWG70001IMedicare ID - Type UnspecifiedPPIN
CARHM08608FMedicaid
CAWG70001KMedicare ID - Type UnspecifiedPPIN
CARHM18553HMedicaid
CAW14270Medicare PIN
CA058609Medicare ID - Type UnspecifiedRH MEDICARE
CA058553Medicare ID - Type UnspecifiedRH MEDICARE
CAWG70001JMedicare ID - Type UnspecifiedPPIN
CAW14270AMedicare PIN
CA95-1683892OtherOTHER INSURANCE
CA058608Medicare ID - Type UnspecifiedRH MEDICARE
CAWG70001FMedicare ID - Type UnspecifiedPPIN