Provider Demographics
NPI:1942397856
Name:STERN, MERLE N (MD)
Entity Type:Individual
Prefix:MRS
First Name:MERLE
Middle Name:N
Last Name:STERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:65 N MADISON AVE
Mailing Address - Street 2:SUITE 615
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5215
Mailing Address - Country:US
Mailing Address - Phone:626-585-8821
Mailing Address - Fax:626-585-8984
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:SUITE 615
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5215
Practice Address - Country:US
Practice Address - Phone:626-585-8821
Practice Address - Fax:626-585-8984
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG587402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG58740Medicare ID - Type Unspecified
E79790Medicare UPIN