Provider Demographics
NPI:1609380187
Name:THE STERNBERG CLINIC INC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THE STERNBERG CLINIC INC A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:STERNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FACS, FASCRS
Authorized Official - Phone:415-821-8000
Mailing Address - Street 1:2100 WEBSTER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2378
Mailing Address - Country:US
Mailing Address - Phone:415-417-3377
Mailing Address - Fax:855-736-3488
Practice Address - Street 1:2100 WEBSTER ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2378
Practice Address - Country:US
Practice Address - Phone:154-173-3774
Practice Address - Fax:855-736-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85776208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABS4441779OtherDEA