Provider Demographics
NPI:1710144167
Name:STAHL, STEPHEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:STAHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1930 PALOMAR POINT WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-5579
Mailing Address - Country:US
Mailing Address - Phone:760-444-9065
Mailing Address - Fax:760-931-8857
Practice Address - Street 1:1930 PALOMAR POINT WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-5579
Practice Address - Country:US
Practice Address - Phone:760-444-9065
Practice Address - Fax:760-931-8857
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34507174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist