Provider Demographics
NPI:1871928416
Name:LUBY, STEPHEN P (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:P
Last Name:LUBY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:473 VIA ORTEGA
Mailing Address - Street 2:Y2E2, MC 4205
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-4121
Mailing Address - Country:US
Mailing Address - Phone:650-723-4129
Mailing Address - Fax:650-725-3402
Practice Address - Street 1:473 VIA ORTEGA
Practice Address - Street 2:Y2E2, MC 4205
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-4121
Practice Address - Country:US
Practice Address - Phone:650-723-4129
Practice Address - Fax:650-725-3402
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
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Provider Licenses
StateLicense IDTaxonomies
VA0101242859207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine