Provider Demographics
NPI:1710224134
Name:KINSEY, STEPHEN LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEWIS
Last Name:KINSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:135 LONGFIELD PL
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-2127
Mailing Address - Country:US
Mailing Address - Phone:925-376-2225
Mailing Address - Fax:925-376-2225
Practice Address - Street 1:135 LONGFIELD PL
Practice Address - Street 2:
Practice Address - City:MORAGA
Practice Address - State:CA
Practice Address - Zip Code:94556-2127
Practice Address - Country:US
Practice Address - Phone:925-376-2225
Practice Address - Fax:925-376-2225
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAGFE24369207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology