Provider Demographics
NPI:1497732507
Name:WILLIAM A STELLAR MD INC
Entity Type:Organization
Organization Name:WILLIAM A STELLAR MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:STELLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-340-5545
Mailing Address - Street 1:39700 BOB HOPE DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-7103
Mailing Address - Country:US
Mailing Address - Phone:760-340-5545
Mailing Address - Fax:760-346-6208
Practice Address - Street 1:39700 BOB HOPE DRIVE
Practice Address - Street 2:SUITE 110
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-7103
Practice Address - Country:US
Practice Address - Phone:760-340-5545
Practice Address - Fax:760-346-6208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ01846ZMedicare ID - Type Unspecified