Provider Demographics
NPI:1316065683
Name:STRAUSBERG, STUART EDWIN (DO)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:EDWIN
Last Name:STRAUSBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11718 BARRINGTON CT
Mailing Address - Street 2:APT 701
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2930
Mailing Address - Country:US
Mailing Address - Phone:818-722-3332
Mailing Address - Fax:
Practice Address - Street 1:11718 BARRINGTON CT
Practice Address - Street 2:APT 701
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-2930
Practice Address - Country:US
Practice Address - Phone:818-722-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A36382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A3638OtherPHYSICIAN LICENSE NUMBER