Provider Demographics
NPI:1528382801
Name:TORNABENE, STEPHEN V (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:V
Last Name:TORNABENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:280 W MACARTHUR BLVD
Mailing Address - Street 2:GME OFFICE, ROOM 1118
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5642
Mailing Address - Country:US
Mailing Address - Phone:510-752-1373
Mailing Address - Fax:510-752-1571
Practice Address - Street 1:280 W MACARTHUR BLVD
Practice Address - Street 2:GME OFFICE, ROOM 1118
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5642
Practice Address - Country:US
Practice Address - Phone:510-752-1373
Practice Address - Fax:510-752-1571
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA108440207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology