Provider Demographics
NPI:1689660359
Name:STERN, DAVID H (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:H
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16133 VENTURA BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2426
Mailing Address - Country:US
Mailing Address - Phone:818-986-6009
Mailing Address - Fax:818-239-4239
Practice Address - Street 1:16133 VENTURA BLVD STE 360
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2426
Practice Address - Country:US
Practice Address - Phone:818-986-6009
Practice Address - Fax:818-239-4239
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG16711207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G167110Medicaid
CAA39876Medicare UPIN
CA00G167110Medicaid
G16711Medicare PIN