Individual
DERRICK STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
33445 PASEO EL LAZO, SAN JUAN CAPISTRANO, CA 92675-1003
(949) 338-3133
(949) 338-3133
Mailing address
33445 PASEO EL LAZO, SAN JUAN CAPISTRANO, CA 92675-1003
(949) 338-3133
(949) 338-3133
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/12/2009
Last updated
09/18/2024
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