Provider Demographics
NPI:1730479502
Name:STEVE STERN PHYSICAL THERAPY
Entity Type:Organization
Organization Name:STEVE STERN PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:805-498-8244
Mailing Address - Street 1:357 CASTILLIAN AVE
Mailing Address - Street 2:357 CASTILLIAN AVE
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91320-3608
Mailing Address - Country:US
Mailing Address - Phone:805-498-8244
Mailing Address - Fax:
Practice Address - Street 1:357 CASTILLIAN AVE
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91320-3608
Practice Address - Country:US
Practice Address - Phone:805-498-8244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT23171261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy