Provider Demographics
NPI:1124096177
Name:STENZLER, LEE MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:MICHAEL
Last Name:STENZLER
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 1:1801 E MARCH LN
Mailing Address - Street 2:STE D400
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210
Mailing Address - Country:US
Mailing Address - Phone:209-464-3615
Mailing Address - Fax:209-464-1311
Practice Address - Street 1:1801 E MARCH LN
Practice Address - Street 2:STE D400
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210
Practice Address - Country:US
Practice Address - Phone:209-464-3615
Practice Address - Fax:209-464-1311
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG535850207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G535850Medicaid
CAG53585OtherMEDICAL LICENSE NUMBER
CAAS2929303OtherDEA NUMBER
CAE19376Medicare UPIN
CA00G535851Medicare PIN
CAG53585OtherMEDICAL LICENSE NUMBER
CA00G535852Medicare PIN