Provider Demographics
NPI:1629394580
Name:ARTHUR LESLIE STEIN MD A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:ARTHUR LESLIE STEIN MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-552-0446
Mailing Address - Street 1:2080 CENTURY PARK E STE 1108
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-2014
Mailing Address - Country:US
Mailing Address - Phone:310-552-0446
Mailing Address - Fax:310-552-5312
Practice Address - Street 1:2080 CENTURY PARK E STE 1108
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2014
Practice Address - Country:US
Practice Address - Phone:310-552-0446
Practice Address - Fax:310-552-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC34438Medicare UPIN