Provider Demographics
NPI:1922120476
Name:TEUBNER, STEPHEN FREDRICK JR (AT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:FREDRICK
Last Name:TEUBNER
Suffix:JR
Gender:M
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 1/2 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4816
Mailing Address - Country:US
Mailing Address - Phone:714-323-8351
Mailing Address - Fax:
Practice Address - Street 1:16007 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90506-0001
Practice Address - Country:US
Practice Address - Phone:310-660-3593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer