Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G23324 | CA |
NPI | 1023066396 |
---|---|
Provider Name | Dr. Jack Henry Stehr |
First Address | Oakland, CA 94609-3424 |
Second Address | Oakland, CA 94609-3424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G233240 | (05) | CA |
A 41916 | (02) |