Provider Demographics
NPI:1316980014
Name:COUVILLION, STEPHEN S (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:COUVILLION
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 1:525 E MICHELTORENA ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-4211
Mailing Address - Country:US
Mailing Address - Phone:805-963-1648
Mailing Address - Fax:805-965-5214
Practice Address - Street 1:525 E MICHELTORENA ST STE A
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-4211
Practice Address - Country:US
Practice Address - Phone:805-963-1648
Practice Address - Fax:805-965-5214
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98191207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2730642-00Medicaid
FL16634Medicare ID - Type Unspecified
FLI39892Medicare UPIN