Provider Demographics
NPI:1881867695
Name:OH, STEPHEN DONGJIN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DONGJIN
Last Name:OH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:29185 BRANWIN ST
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-5877
Mailing Address - Country:US
Mailing Address - Phone:312-636-9389
Mailing Address - Fax:951-200-6797
Practice Address - Street 1:29185 BRANWIN ST
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-5877
Practice Address - Country:US
Practice Address - Phone:312-636-9389
Practice Address - Fax:951-200-6797
Is Sole Proprietor?:No
Enumeration Date:2008-04-12
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A 9711207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology