Individual
DR. STEPHEN S BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4060 4TH AVE, SUITE 310, SAN DIEGO, CA 92103-2116
(619) 297-4707
(858) 429-7927
Mailing address
PO BOX 33865, SAN DIEGO, CA 92163-3865
(858) 888-7700
(858) 888-7721
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A44719
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ461Y
MEDICARE PTAN FOR GHP
CA
Enumeration date
06/23/2006
Last updated
03/18/2020
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