Provider Demographics
NPI:1578675021
Name:MEISEL, STEPHEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:MEISEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2811 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 900
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4803
Mailing Address - Country:US
Mailing Address - Phone:800-398-8999
Mailing Address - Fax:800-830-3069
Practice Address - Street 1:2811 WILSHIRE BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4803
Practice Address - Country:US
Practice Address - Phone:800-398-8999
Practice Address - Fax:800-830-3069
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG16853207U00000X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology