Provider Demographics
NPI:1700406121
Name:SEGAL, STEPHEN EDWIN (RPH)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EDWIN
Last Name:SEGAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3855 HEALTH SCIENCES DR # 845
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-1503
Mailing Address - Country:US
Mailing Address - Phone:858-822-6094
Mailing Address - Fax:858-822-6097
Practice Address - Street 1:3855 HEALTH SCIENCES DR # 845
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-1503
Practice Address - Country:US
Practice Address - Phone:858-822-6094
Practice Address - Fax:858-822-6097
Is Sole Proprietor?:No
Enumeration Date:2020-04-26
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA452781835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology