Provider Demographics
NPI:1942332515
Name:DI STEFANO, LUIGI (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIGI
Middle Name:
Last Name:DI STEFANO
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 1:701 WELCH RD
Mailing Address - Street 2:BLDG C
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1709
Mailing Address - Country:US
Mailing Address - Phone:650-723-9215
Mailing Address - Fax:650-723-0121
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-9215
Practice Address - Fax:650-723-0121
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA101791207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program