Stephanie B Long, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A128190 Issued in CA

Practice address

1239 Arden Rd # MC 1/8
Pasadena, CA 91106-4135

Phone

(626) 395-6393

Fax

(626) 585-1522

NPI assigned

Jun 25, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1043448236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 ARDEN RD # MC 1/8",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064135",
            "telephone_number": "626-395-6393",
            "fax_number": "626-585-1522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 ARDEN RD # MC 1/8",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911064135",
            "telephone_number": "626-395-6393",
            "fax_number": "626-585-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "STEPHANIE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Serrato Lone
• Cameron Elliott Long
• Charles Laurence Long, MD
• Christopher Patrick Long, MD
• Malvin Long
• Gloria Longin
• Angela Lucille Longo, OTR/L
• Nicholas Longren
• Jonathan Longtain
• Sandra Maria Lonsdale-Campo, MS OTR/L

• Family Medicine Physician in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.