Provider Demographics
NPI:1437444858
Name:CONE, STEPHANIE ELISE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ELISE
Last Name:CONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ELISE
Other - Last Name:HARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4060 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1608
Mailing Address - Country:US
Mailing Address - Phone:619-280-4213
Mailing Address - Fax:619-795-9847
Practice Address - Street 1:4060 FAIRMOUNT AVE
Practice Address - Street 2:PEDIATRICS DEPARTMENT
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105
Practice Address - Country:US
Practice Address - Phone:619-255-9154
Practice Address - Fax:619-795-9847
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ67851208000000X
390200000X
CAA123929208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
109509OtherTHE AMERICAN BOARD OF PEDIATRICS