Provider Demographics
NPI:1891798112
Name:STEMMER, PAUL F (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:STEMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 N CHINA LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-3130
Mailing Address - Country:US
Mailing Address - Phone:760-446-3551
Mailing Address - Fax:760-499-3393
Practice Address - Street 1:900 N HERITAGE DR STE A
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-5540
Practice Address - Country:US
Practice Address - Phone:760-446-3700
Practice Address - Fax:760-446-3705
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63347208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG63347OtherCA LICENSE
BS1590668OtherDEA
E85484Medicare UPIN
CAP00690822Medicare PIN
BS1590668OtherDEA
CACB214082Medicare PIN