Provider Demographics
NPI:1689678013
Name:STEK, ALICE M (MD)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:M
Last Name:STEK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1640 MARENGO ST
Mailing Address - Street 2:STE 505
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1038
Mailing Address - Country:US
Mailing Address - Phone:323-221-3270
Mailing Address - Fax:323-225-6284
Practice Address - Street 1:1400 S GRAND AVE
Practice Address - Street 2:STE 805
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3011
Practice Address - Country:US
Practice Address - Phone:213-763-1500
Practice Address - Fax:213-763-1505
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-08-22
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Provider Licenses
StateLicense IDTaxonomies
CAA51981207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOA519810Medicaid
CAE89389Medicare UPIN
CAWA51981CMedicare ID - Type Unspecified