Provider Demographics
NPI:1508109901
Name:STERN, RACHEL JUDITH (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:JUDITH
Last Name:STERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3108
Mailing Address - Country:US
Mailing Address - Phone:818-522-4700
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:415-206-5164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251X00000X, 171M00000X, 332U00000X, 385H00000X, 390200000X
CAA133215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No251X00000XAgenciesSupports Brokerage
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No332U00000XSuppliersHome Delivered Meals
No385H00000XRespite Care FacilityRespite Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program