Stephen Michael Millbern, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C36162 Issued in CA

Practice address

5463 Fremontia LN
San Diego, CA 92115-1007

Phone

(619) 265-7810

Fax

(619) 265-8929

NPI assigned

Jul 27, 2006

Last updated

Apr 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1417971839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5463 FREMONTIA LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151007",
            "telephone_number": "619-265-7810",
            "fax_number": "619-265-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5463 FREMONTIA LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921151007",
            "telephone_number": "619-265-7810",
            "fax_number": "619-265-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLBERN",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C36162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C361620",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "00C361620",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith Richard Millard, DENTIST
• Marie Maynard Millard, MFT
• Renee Evelyn Millard, F.A.C.T. CERT #382
• Sean Millard
• William Wilbur Millard II, M.D.
• Marlene May Millen, MD
• Millennium Health, LLC
• Marilyn Miller Betancourt
• Shanna Michael Miller-Nabas, RDN
• Adam Miller

• Anesthesiology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; 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.