Robert Achille De Stefano, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A21674 Issued in CA

Practice address

23501 Park Sorrento
Calabasas, CA 91302-1308

Phone

(818) 222-7495

Fax

(818) 222-7498

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1700879327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23501 PARK SORRENTO",
            "address_2": "SUITE 216",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021308",
            "telephone_number": "818-222-7495",
            "fax_number": "818-222-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23501 PARK SORRENTO",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913021308",
            "telephone_number": "818-222-7495",
            "fax_number": "818-222-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE STEFANO",
        "first_name": "ROBERT",
        "middle_name": "ACHILLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A21674",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A21674",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Calabasas, CA
• Providers in Calabasas, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.