Provider Demographics
NPI:1770515587
Name:STILES, STEVEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:STILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2856
Mailing Address - Country:US
Mailing Address - Phone:818-996-3400
Mailing Address - Fax:818-996-8643
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-996-3400
Practice Address - Fax:818-996-8643
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG14053207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG14053OtherCA MEDICAL LICENSE
CA00G140530Medicaid
0153950001Medicare NSC
CAA39159Medicare UPIN
CAWG14053AMedicare PIN