Doctor Name: | GORDANA STEVANOVIC |
NPI Number: | 1083611602 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | A48595 |
Business Practice Address: | 13112 Evening Creek Dr S San Diego, CA - 921284108 |
Business Phone Number: | 8188584390 |
Business Fax Number: | 3106987054 |
Mailing Address: | 2374 E Pacifica Pl, RANCHO DOMINGUEZ |
State: | CA |
Postal Code: | 902206214 |
Phone Number: | 3102253244 |
Fax Number: | 3106987054 |
NPI Enumeration Date: | 06/29/2005 |
NPI Last Update Date: | 01/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A48595 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |