Provider Demographics
NPI:1437276565
Name:LESSER, STEPANIE BOKUM (RPT REGISTERED PHYSI)
Entity Type:Individual
Prefix:MRS
First Name:STEPANIE
Middle Name:BOKUM
Last Name:LESSER
Suffix:
Gender:F
Credentials:RPT REGISTERED PHYSI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103
Mailing Address - Country:US
Mailing Address - Phone:619-291-4472
Mailing Address - Fax:858-560-5494
Practice Address - Street 1:7450 HAZARD CENTER DR S
Practice Address - Street 2:DOUBLETREE HOTEL
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-899-3619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT6928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist