Basic Information
| Provider Information | |||||||||
| NPI: | 1356438113 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALKSTEIN | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 50 DOUGLAS DRIVE SUITE 39 | ||||||||
| Address2: | HEALTH SERVICES ADMINISTRATION | ||||||||
| City: | MARTINEZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945534098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259575429 | ||||||||
| FaxNumber: | 9259575401 | ||||||||
| Practice Location | |||||||||
| Address1: | 2500 ALHAMBRA AVENUE | ||||||||
| Address2: | CONTRA COSTA REGIONAL MEDICAL CENTER AND HEALTH CENTERS | ||||||||
| City: | MARTINEZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945533156 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9253705110 | ||||||||
| FaxNumber: | 9253705142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G25872 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.