| Kevin Stephanoff, M.d., Inc. | |
|
23700 Camino Del Sol Torrance CA 90505-5017 | |
| (310) 308-9014 | |
| Not Available |
| Full Name | Kevin Stephanoff, M.d., Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 23700 Camino Del Sol, Torrance, California |
| Authorized Official Name and Position | Kevin Stephanoff (PRESIDENT) |
| Authorized Official Contact | 3103089014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Stephanoff, M.d., Inc. 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 308-9014 | Kevin Stephanoff, M.d., Inc. 23700 Camino Del Sol Torrance CA 90505-5017 Ph: (310) 308-9014 |
| NPI Number | 1003547373 |
|---|---|
| Provider Enumeration Date | 06/18/2022 |
| Last Update Date | 06/24/2022 |
| Certification Date | 06/24/2022 |
| Medicare PECOS PAC ID | 5496138935 |
|---|---|
| Medicare Enrollment ID | O20220817000874 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003547373 | NPI | - | NPPES |
| 1962907386 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kevin Stephanoff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962907386 PECOS PAC ID: 1557770864 Enrollment ID: I20210517002159 |
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