# STACY MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861830648
- **Authorized official:** DR. STEVEN HARLAN FLORMAN M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (323) 584-0779

## Contact information

- **Practice address:** 4580 PACIFIC BLVD, VERNON, CA 90058-2208
- **Practice address phone:** (323) 584-0779
- **Practice address fax:** (323) 584-2282
- **Mailing address:** 4580 PACIFIC BLVD, VERNON, CA 90058-2208
- **Mailing address phone:** (323) 584-0779
- **Mailing address fax:** (323) 584-2282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/13/2013
- **Last updated:** 06/13/2013