Provider Demographics
NPI:1922301084
Name:STEPHEN J. HELVIE MD INC
Entity Type:Organization
Organization Name:STEPHEN J. HELVIE MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HELVIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-395-1234
Mailing Address - Street 1:2323 16TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3453
Mailing Address - Country:US
Mailing Address - Phone:661-395-1234
Mailing Address - Fax:661-395-1292
Practice Address - Street 1:2323 16TH ST STE 203
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3453
Practice Address - Country:US
Practice Address - Phone:661-395-1234
Practice Address - Fax:661-395-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37489174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5454617Medicaid
CA00C374890Medicare PIN
CA5454617Medicaid
CAA36640Medicare UPIN