Provider Demographics
NPI:1427134832
Name:STEIN, SIMA (MD)
Entity type:Individual
Prefix:MRS
First Name:SIMA
Middle Name:
Last Name:STEIN
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 1:105 N BASCOM AVE #102
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128
Mailing Address - Country:US
Mailing Address - Phone:408-292-0100
Mailing Address - Fax:408-292-0431
Practice Address - Street 1:105 N BASCOM AVE #102
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128
Practice Address - Country:US
Practice Address - Phone:408-292-0100
Practice Address - Fax:408-292-0431
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55498208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A554980Medicaid
CAA55498OtherCALIFORNIA STATE LICENCE