Basic Information
| Provider Information | |||||||||
| NPI: | 1528382801 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORNABENE | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | V. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 W MACARTHUR BLVD | ||||||||
| Address2: | GME OFFICE, ROOM 1118 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946115642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107521373 | ||||||||
| FaxNumber: | 5107521571 | ||||||||
| Practice Location | |||||||||
| Address1: | 280 W MACARTHUR BLVD | ||||||||
| Address2: | GME OFFICE, ROOM 1118 | ||||||||
| City: | OAKLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 946115642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5107521373 | ||||||||
| FaxNumber: | 5107521571 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2010 | ||||||||
| LastUpdateDate: | 02/11/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | A108440 | CA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.