Provider Demographics
NPI:1700847704
Name:STEPHENS, PATRICIA N (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:N
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17742 BEACH BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6818
Mailing Address - Country:US
Mailing Address - Phone:714-848-0868
Mailing Address - Fax:714-848-2248
Practice Address - Street 1:17742 BEACH BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6818
Practice Address - Country:US
Practice Address - Phone:714-848-0868
Practice Address - Fax:714-848-2248
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC412752080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine