Provider Demographics
NPI:1679547673
Name:MORRIS, STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:MORRIS
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 1:1000 N SEPULVEDA BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-5975
Mailing Address - Country:US
Mailing Address - Phone:415-296-5290
Mailing Address - Fax:415-296-5299
Practice Address - Street 1:1000 N SEPULVEDA BLVD STE 280
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5975
Practice Address - Country:US
Practice Address - Phone:415-296-5290
Practice Address - Fax:415-296-5299
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA923922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN