Provider Demographics
NPI:1538222013
Name:DONIGER, STEPHANIE JOY (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOY
Last Name:DONIGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 THE STRAND REAR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4318
Mailing Address - Country:US
Mailing Address - Phone:562-243-5253
Mailing Address - Fax:718-780-3153
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2358
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80240208000000X, 2080P0204X
TXV31662080P0204X
NY2437062080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A802400OtherMEDICAL PROVIDER NUMBER
CA00A802400Medicaid
CA00A802400OtherMEDICAL PROVIDER NUMBER
CAWA80240AMedicare PIN