Individual
DR. STEPHEN M SENTOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 FAIR OAKS AVE, SOUTH PASADENA, CA 91030-1814
(626) 396-2900
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
(626) 775-3514
(626) 218-5310
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
79913
MA
208600000X
Surgery Physician
G65171
CA
208C00000X
Colon & Rectal Surgery Physician
79913
MA
208C00000X
Colon & Rectal Surgery Physician
Primary
G65171
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110054757A
—
MA
Enumeration date
04/07/2006
Last updated
11/11/2020
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