Provider Demographics
NPI:1306971262
Name:KRISTINE PERCY MD & LAUREN STEARNS MD, INC.
Entity type:Organization
Organization Name:KRISTINE PERCY MD & LAUREN STEARNS MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATION OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PERCY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-671-2936
Mailing Address - Street 1:539 S BREA BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5377
Mailing Address - Country:US
Mailing Address - Phone:714-671-2936
Mailing Address - Fax:714-671-2938
Practice Address - Street 1:539 S BREA BLVD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5377
Practice Address - Country:US
Practice Address - Phone:714-671-2936
Practice Address - Fax:714-671-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1205921756OtherINDIVIDUAL NPI NUMBER
CA1972697605OtherINDIVIDUAL NPI NUMBER
CA1972697605OtherINDIVIDUAL NPI NUMBER
CAWA69475BMedicare ID - Type UnspecifiedSTEARNS PPIN
CAWG77388EMedicare ID - Type UnspecifiedPERCY PPIN
CAG 10904Medicare UPIN
CAH 29792Medicare UPIN