Provider Demographics
NPI:1376634501
Name:HUTHSTEINER, GEORGE II (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:HUTHSTEINER
Suffix:II
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 1:153 BAY SHORE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-3452
Mailing Address - Country:US
Mailing Address - Phone:562-424-8307
Mailing Address - Fax:562-424-2007
Practice Address - Street 1:2600 REDONDO AVE STE 400
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2330
Practice Address - Country:US
Practice Address - Phone:562-424-8307
Practice Address - Fax:562-424-2007
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40478207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G404780Medicaid
CAWG40478AOtherMEDICARE
CAA48235Medicare UPIN