Provider Demographics
NPI:1376539981
Name:STERNBERG, HARVEY JOEL (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:JOEL
Last Name:STERNBERG
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:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:MOUNT SHASTA
Mailing Address - State:CA
Mailing Address - Zip Code:96067-0339
Mailing Address - Country:US
Mailing Address - Phone:530-926-5613
Mailing Address - Fax:530-926-8798
Practice Address - Street 1:50 ALAMO AVE
Practice Address - Street 2:
Practice Address - City:WEED
Practice Address - State:CA
Practice Address - Zip Code:96094-2352
Practice Address - Country:US
Practice Address - Phone:530-938-3491
Practice Address - Fax:530-938-2662
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080076462OtherRAILROAD MEDICARE
CA00G520170Medicaid
A89941Medicare UPIN
CA00G520170Medicaid
CA00G520170Medicare ID - Type Unspecified