Provider Demographics
NPI:1740617273
Name:STERN, EARL L (MD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:L
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EARL
Other - Middle Name:L
Other - Last Name:STERN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, INC
Mailing Address - Street 1:10 MELBA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94132-1560
Mailing Address - Country:US
Mailing Address - Phone:415-661-3434
Mailing Address - Fax:415-661-3435
Practice Address - Street 1:10 MELBA AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94132-1560
Practice Address - Country:US
Practice Address - Phone:415-661-3434
Practice Address - Fax:415-661-3435
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A175190207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376626010OtherEARL L. STERN MD, INC