Provider Demographics
NPI:1902086374
Name:HEPATOLOGY AND GASTROENTEROLOGY ASSOCIATES INC
Entity Type:Organization
Organization Name:HEPATOLOGY AND GASTROENTEROLOGY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:STEADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-766-9852
Mailing Address - Street 1:1383 N MCDOWELL BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94954-1190
Mailing Address - Country:US
Mailing Address - Phone:415-668-9371
Mailing Address - Fax:415-668-9191
Practice Address - Street 1:1383 N MCDOWELL BLVD
Practice Address - Street 2:STE 110
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94954-1190
Practice Address - Country:US
Practice Address - Phone:707-766-9852
Practice Address - Fax:707-766-8431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44200207RG0100X
207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty