Stephanie Renee Booth, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

G062886 Issued in CA

Practice address

4580 Atlantic Avenue
Long Beach, CA 90807-0503

Phone

(562) 335-0551

NPI assigned

May 1, 2008

Last updated

May 1, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Renee Booth-Millen Other name

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": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1851567739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7503",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908070503",
            "telephone_number": "562-335-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 ATLANTIC AVENUE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908070503",
            "telephone_number": "562-335-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTH",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G062886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "BOOTH-MILLEN",
            "middle_name": "RENEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Althea Bonsol, NP
• Janaeja Bonton
• Latrice Marie Booker, BSN, RN
• Raymond Lee Booker I, MA, LPCC
• April Lynn Boos
• La Trisha Maureen Boothe
• Erica Elizabeth Bootz
• Marissa Lydia Borboa, ASW
• Tamara Falice Borden
• Elizabeth Borders

• Pediatrics Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.