Provider Demographics
NPI:1295762409
Name:HESSELTINE, STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:HESSELTINE
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 1:2125 OAK GROVE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2536
Mailing Address - Country:US
Mailing Address - Phone:925-296-7150
Mailing Address - Fax:925-296-7171
Practice Address - Street 1:2125 OAK GROVE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2536
Practice Address - Country:US
Practice Address - Phone:925-296-7150
Practice Address - Fax:925-296-7171
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA945522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A9455211Medicare PIN
CA00A9455218Medicare PIN
CA00A9455221Medicare PIN
CA00A945524Medicare PIN
CA00A945527Medicare PIN
CA00A945521Medicare PIN
CA00A9455210Medicare PIN
CA00A9455215Medicare PIN
CAP00325986Medicare PIN
CA00A9455219Medicare PIN
CA00A9455212Medicare PIN
CA00A9455216Medicare PIN
CA00A945526Medicare PIN
CA00A945520Medicare PIN
I42827Medicare UPIN
CA00A945522Medicare PIN
CA00A9455220Medicare PIN
CA00A945525Medicare PIN
CA00A945528Medicare PIN
CA00A945529Medicare PIN
CA00A9455213Medicare PIN
CA00A9455214Medicare PIN
CA00A9455217Medicare PIN