Provider Demographics
NPI:1659385151
Name:WELLS, STEPHEN R (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:WELLS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:110 TAMPICO
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-935-5356
Mailing Address - Fax:925-935-1070
Practice Address - Street 1:110 TAMPICO
Practice Address - Street 2:SUITE 220
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-935-5356
Practice Address - Fax:925-935-1070
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2010-04-20
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Provider Licenses
StateLicense IDTaxonomies
CAA49731207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A497310Medicare PIN