Provider Demographics
NPI:1851572986
Name:STIGEN, THERESA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:STIGEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:577 E ELDER ST STE K
Mailing Address - Street 2:
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3079
Mailing Address - Country:US
Mailing Address - Phone:760-983-4024
Mailing Address - Fax:760-723-9010
Practice Address - Street 1:577 E ELDER ST STE K
Practice Address - Street 2:
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-983-4024
Practice Address - Fax:760-723-9010
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108021207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology