Provider Demographics
NPI:1760461719
Name:STEIN, DAVID ET (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ET
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:2440 SAMARITAN DR
Mailing Address - Street 2:#1
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:408-626-7375
Mailing Address - Fax:408-626-7368
Practice Address - Street 1:2440 SAMARITAN DR
Practice Address - Street 2:#1
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-626-7375
Practice Address - Fax:408-626-7368
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39186207RG0100X, 207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A47729Medicare UPIN
00G391860Medicare ID - Type Unspecified