Provider Demographics
NPI:1619241973
Name:STEPHEN K. ENG, D.O. INC.
Entity Type:Organization
Organization Name:STEPHEN K. ENG, D.O. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-281-5998
Mailing Address - Street 1:2275 HUNTINGTON DR
Mailing Address - Street 2:#337
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2640
Mailing Address - Country:US
Mailing Address - Phone:626-281-5998
Mailing Address - Fax:626-288-6779
Practice Address - Street 1:309 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4308
Practice Address - Country:US
Practice Address - Phone:323-725-4209
Practice Address - Fax:323-725-4363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5336207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty