Provider Demographics
NPI:1164795068
Name:DERRINGTON, STEPHEN (DO, INC)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:DERRINGTON
Suffix:
Gender:M
Credentials:DO, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5806 VAN ALLEN WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7355
Mailing Address - Country:US
Mailing Address - Phone:760-721-4000
Mailing Address - Fax:760-701-9596
Practice Address - Street 1:5806 VAN ALLEN WAY STE 101
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7355
Practice Address - Country:US
Practice Address - Phone:760-721-4000
Practice Address - Fax:760-701-9596
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14038208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation