Provider Demographics
NPI:1588738678
Name:KOBAYASHI, STEPHEN AKIRA (MD GENERAL SURGEON)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:AKIRA
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:MD GENERAL SURGEON
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:152 PIONEER LANE
Mailing Address - Street 2:SUITE F
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93514
Mailing Address - Country:US
Mailing Address - Phone:760-873-3503
Mailing Address - Fax:760-873-7544
Practice Address - Street 1:152 PIONEER LANE
Practice Address - Street 2:SUITE F
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514
Practice Address - Country:US
Practice Address - Phone:760-873-3503
Practice Address - Fax:760-873-7544
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA222090208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A222090Medicaid
00A222090Medicare ID - Type Unspecified
CA00A222090Medicaid