Individual provider Active NPI

Kevin Stephanoff, MD

  • Psychiatry Physician
  • Torrance, CA
National Provider Identifier
1962907386
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A163337 Issued in CA
Practice address
23700 Camino del Sol
Torrance, CA 90505-5017
Phone
(310) 530-1151
NPI assigned
Mar 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 163337 CA
Psychiatry Physician 2084P0800X A163337 CA Primary

Addresses

Primary practice location

23700 Camino del Sol
Torrance, CA 90505-5017

Mailing address

PO Box 525
Redondo Beach, CA 90277-0525

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210517002159 CA Practitioner - Psychiatry 1557770864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kevin Stephanoff MD IncGroup PAC ID 5496138935, 3 clinicians

Practice addresses (Care Compare)

Long Beach, CA 90806
Phone (844) 562-1212

Hospital & facility affiliations

  • Lac/Harbor-UCLA Med Center Hospital, Torrance, CA, CCN 050376
  • College Medical Center Hospital, Long Beach, CA, CCN 050776
  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351
  • Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373
  • Martin Luther King, Jr. Community Hospital Hospital, Los Angeles, CA, CCN 050779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
163337CAMDSpecialist
A163337CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kevin Stephanoff, M.D., Inc. Psychiatry CurrentSince Jun 22, 2022 Accepting new patients
Comprehensive Psychiatric Services, a Medical Group Psychiatry CurrentSince Nov 1, 2021 Accepting new patients
Collaborative Neuroscience Network, LLC Past Accepting new patients

Locations

6167 Bristol Pkwy
Ste 260
Culver City, CA 90230
Phone (424) 331-5604

2600 Redondo Ave
Ste 500
Long Beach, CA 90806
Phone (310) 222-3177

23700 Camino del Sol
Torrance, CA 90505
Phone (310) 530-1151

3100 Oak Rd
Ste 270
Walnut Creek, CA 94597
Phone (925) 944-9711

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1962907386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 525",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902770525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 CAMINO DEL SOL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055017",
            "telephone_number": "310-530-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHANOFF",
        "first_name": "KEVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2022-11-10",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "163337",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A163337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.