Individual
DR. DWIGHT GREGORY STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
323 N PRAIRIE AVE, SUITE 320, INGLEWOOD, CA 90301-4502
(310) 671-5800
(310) 671-5810
Mailing address
323 N PRAIRIE AVE STE 320, INGLEWOOD, CA 90301-4505
(310) 671-5800
(310) 671-5810
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2206
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
753069253
BLUE CROSS
CA
01
—
CB277243
MEDICARE
CA
01
—
ZZZ39493Z
BLUE SHIELD OF CALIFORNIA
CA
05
—
ZZZ86328Z
—
CA
Enumeration date
07/25/2006
Last updated
01/09/2023
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