Provider Demographics
NPI:1972603371
Name:HIGHTOWER, STEPHEN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:HIGHTOWER
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 1:2888 LONG BEACH BLVD.
Mailing Address - Street 2:SUITE #340
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1552
Mailing Address - Country:US
Mailing Address - Phone:562-595-6891
Mailing Address - Fax:562-490-7271
Practice Address - Street 1:2888 LONG BEACH BLVD.
Practice Address - Street 2:SUITE #340
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1552
Practice Address - Country:US
Practice Address - Phone:562-595-6891
Practice Address - Fax:562-490-7271
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG084688208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ75909ZMedicaid
CAG87926Medicare UPIN
CAZZZ75909ZMedicaid