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Individual
STEPHEN EDWARD KISHINEFF
Active
Individual
STEPHEN EDWARD KISHINEFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G66208
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G662080
BLUE SHIELD
—
05
—
00G662080
—
CA
01
—
930035451
RAILROAD MEDICARE
—
01
—
G66208
BLUE CROSS
—
Enumeration date
04/05/2006
Last updated
09/20/2012
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