Provider Demographics
NPI:1386758399
Name:CULVER, STEPHANIE M (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:CULVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 TORRANCE BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-540-3610
Mailing Address - Fax:310-944-9322
Practice Address - Street 1:4201 TORRANCE BLVD STE 260
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-540-3610
Practice Address - Fax:310-944-9322
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066279207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A662790Medicaid
G90004Medicare UPIN
A66279Medicare ID - Type Unspecified