Provider Demographics
NPI:1821069535
Name:ANDREW JAMES STEIN M D
Entity Type:Organization
Organization Name:ANDREW JAMES STEIN M D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE SUPERVISOR/BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-297-0550
Mailing Address - Street 1:13690 E 14TH ST
Mailing Address - Street 2:SUITE # 200
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2582
Mailing Address - Country:US
Mailing Address - Phone:510-297-0550
Mailing Address - Fax:510-297-0558
Practice Address - Street 1:13690 E 14TH ST
Practice Address - Street 2:SUITE # 200
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2582
Practice Address - Country:US
Practice Address - Phone:510-297-0550
Practice Address - Fax:510-297-0558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75352174400000X
CAOT 2258225XH1200X
CAOT 2257225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4407354OtherAETNA PROVIDER #
CA00G753520OtherBLUECOSS OF CA PROVIDER #
CAZZZ04834ZOtherBLUESHIELD OF CA PROVIDER
CAZZZ04834ZOtherBLUESHIELD OF CA PROVIDER
CA00G753520OtherBLUECOSS OF CA PROVIDER #
CA4407354OtherAETNA PROVIDER #