Provider Demographics
NPI:1548461346
Name:STEHR, WOLFGANG (MD)
Entity type:Individual
Prefix:
First Name:WOLFGANG
Middle Name:
Last Name:STEHR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 52ND ST
Mailing Address - Street 2:SUITE 4100
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1810
Mailing Address - Country:US
Mailing Address - Phone:510-428-3022
Mailing Address - Fax:510-428-3405
Practice Address - Street 1:744 52ND ST
Practice Address - Street 2:SUITE 4100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1810
Practice Address - Country:US
Practice Address - Phone:510-428-3022
Practice Address - Fax:510-428-3405
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC542962086S0120X, 174400000X, 208600000X
NV195042086S0120X
NMMD2016-08142086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV19504OtherMD NEVADA
NV12146131OtherCAQH
CAC54296OtherMD CALI