Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | C32471 | CA |
NPI | 1013964774 |
---|---|
Provider Name | Jay J Stein |
First Address | Los Angeles, CA 90048-6101 |
Second Address | Los Angeles, CA 90048-6101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2006 |
Last Update Date | 18/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A34948 | (02) | CA |