Provider Demographics
NPI:1407963812
Name:MORRISON, STEPHEN L (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:MORRISON
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0302
Practice Address - Country:US
Practice Address - Phone:916-536-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24805207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA011878OtherHEALTH NET
CA000810342975OtherPHCS
CA1089844OtherGREAT WEST
CA3188OtherFIRST HEALTH
CA725657OtherUNITED HEALTHCARE
CAA24805OtherBLUE CROSS
CA3615556OtherCIGNA
CA4056641OtherAETNA
CA90020078OtherPACIFICARE
CAMCMG170300OtherWESTERN HEALTH ADVANTAGE
CA13477OtherINTERPLAN
CA3188OtherFIRST HEALTH
CAMCMG170300OtherWESTERN HEALTH ADVANTAGE