Provider Demographics
NPI:1891710315
Name:DROGIN, STEPHEN GORDON (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:GORDON
Last Name:DROGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6734 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6720
Mailing Address - Country:US
Mailing Address - Phone:530-344-8180
Mailing Address - Fax:
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:NCHS VAMC SACRAMENTO- INTERNAL MEDICINE
Practice Address - City:CARMICHAEL, CA
Practice Address - State:CA
Practice Address - Zip Code:95655
Practice Address - Country:US
Practice Address - Phone:916-843-9196
Practice Address - Fax:916-366-5475
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21168207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine