Individual
STEPHEN L. GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(619) 528-5000
Mailing address
393 E WALNUT ST, 3RD FLOOR PHR SYSTEMS, PASADENA, CA 91188-0001
(000) 000-0000
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G33122
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G331220
—
CA
Enumeration date
11/29/2006
Last updated
11/29/2007
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