Provider Demographics
NPI:1790846095
Name:KATZ, STANLEY NORMAN (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:NORMAN
Last Name:KATZ
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 1:31938 TEMECULA PKWY STE A337
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6810
Mailing Address - Country:US
Mailing Address - Phone:951-303-6900
Mailing Address - Fax:951-303-2900
Practice Address - Street 1:31150 TEMECULA PKWY STE 104
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-2921
Practice Address - Country:US
Practice Address - Phone:951-303-6900
Practice Address - Fax:951-303-2900
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG203155207N00000X
FLME 83086207N00000X, 207N00000X
GA054680207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00433029OtherRAILROAD MEDICARE
NJ455739U4LMedicare PIN
NJP00433029OtherRAILROAD MEDICARE
GAGRP6800Medicare PIN
GADC4061Medicare PIN