Individual
DR. JEFFREY LYLE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838
Mailing address
100 E CALIFORNIA BLVD, PASADENA, CA 91105-3205
(626) 568-8838
(626) 583-8838
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
7997
SD
207W00000X
Ophthalmology Physician
C148445
CA
207W00000X
Ophthalmology Physician
M-15046
ID
207W00000X
Ophthalmology Physician
MD 60151762
WA
207W00000X
Ophthalmology Physician
MD151338
OR
207W00000X
Ophthalmology Physician
MD438137
PA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
M-15046
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760541569
GROUP NPI
CA
Enumeration date
11/03/2009
Last updated
11/04/2021
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