Stephen Docherty, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A5085 Issued in CA

Practice address

438 W Las Tunas Dr
San Gabriel, CA 91776-1216

Phone

(626) 289-5454

NPI assigned

May 30, 2006

Last updated

Dec 14, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1912954173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE 57430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900740001",
            "telephone_number": "800-819-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 W LAS TUNAS DR",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761216",
            "telephone_number": "626-289-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCHERTY",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A5085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A50850",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20A5085",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX50850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trey Dickerson
• Dignity Health (San Gabriel Valley Medical Center)
• Crystal Dinh, OD
• Andrew Thuc DO, D.D.S.
• Dominique Gia Doan, M.D.
• Steven Dohi
• Dominique Gia-Gia Doan a Professional Medical Corporation
• Dr. Cheng's Dental Office,Chaur Yang Cheng D.D.S. Inc. General Partner
• Dr. Paul Tripp D.C. LLC
• Dreamweaver Consultancy, a Medical Corporation (San Gabriel Valley Urgent Care)

• Emergency Medicine Physician in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.