Provider Demographics
NPI:1831462118
Name:FIKERT, STACY ANN (MD)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:ANN
Last Name:FIKERT
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 1:25262 TERRENO DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5528
Mailing Address - Country:US
Mailing Address - Phone:310-293-5919
Mailing Address - Fax:
Practice Address - Street 1:25262 TERRENO DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5528
Practice Address - Country:US
Practice Address - Phone:310-293-5919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA126201207P00000X
NY271454207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine