Provider Demographics
NPI:1821250564
Name:STOTESBERY, KORY DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:KORY
Middle Name:DAVID
Last Name:STOTESBERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2970 CAMINO DIABLO STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-4001
Mailing Address - Country:US
Mailing Address - Phone:925-360-5264
Mailing Address - Fax:
Practice Address - Street 1:3100 OAK RD STE 270
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94597-2078
Practice Address - Country:US
Practice Address - Phone:925-944-1733
Practice Address - Fax:925-944-9709
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A127982084P0804X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry