Provider Demographics
NPI:1134166671
Name:BUGHI, STEFAN (MD)
Entity type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
Last Name:BUGHI
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:PO BOX 31218
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0218
Mailing Address - Country:US
Mailing Address - Phone:626-457-5839
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-2806
Practice Address - Fax:323-442-5425
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43274207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA110090571OtherRAILROAD MEDICARE
CA1356390009OtherGROUP NPI
CACE1617OtherGROUP RAILROAD MEDICARE
CA00A432740Medicaid
CAGR0016910OtherGROUP MEDICAID
CA00A432740OtherBLUE SHIELD
CAW11675OtherGROUP MEDICARE PIN
CA00A432740Medicaid
CA1356390009OtherGROUP NPI