Provider Demographics
NPI:1649204520
Name:STANOWICZ, STEVEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:STANOWICZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2231
Mailing Address - Country:US
Mailing Address - Phone:714-538-8556
Mailing Address - Fax:714-538-1082
Practice Address - Street 1:1506 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2231
Practice Address - Country:US
Practice Address - Phone:714-538-8556
Practice Address - Fax:714-538-1082
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22888207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG22888OtherMEDICAL LICENSE
CA00G228880Medicaid
CAG22888Medicare PIN
CAA41758Medicare UPIN