STEFAN R JIBODH (NPI# 1508875642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508875642 |
| Entity Type | Individual |
| Full Name | STEFAN R JIBODH |
| Credential | M.D. |
| Practice Address |
1425 S Main St Dept of Orthopedics, Mob 1st Floor Walnut Creek CA 94596-5318 |
| Practice Telephone | 9252954130 |
| Mailing Telephone | 9252954130 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2012-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
A104528 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1425 S MAIN ST DEPT OF ORTHOPEDICS, MOB 1ST FLOOR |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94596-5318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356342638 | Ingrid Wendy Fernandes | Internal Medicine | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2005-08-09 |
| 1982221297 | Michelle Nhumai Huynh | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-07-02 |
| 1144869322 | Darrell James David | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2020-01-05 |
| 1306484530 | Kayla Galanter | Pharmacist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-12-18 |
| 1184260804 | Carol Jean Mcmenamy | Social Worker | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-18 |
| 1871138990 | Gloria Yatmen Lai | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-11-12 |
| 1851945901 | Zsanell Go | Physical Therapist | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-07-26 |
| 1043776453 | Bridget Rochios | Registered Nurse | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1518423920 | Britnie Lee Milam | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-11 |
| 1326503244 | Megan R Moore | Respiratory Therapist, Registered | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2019-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917229 | Alison M Khaddour | Behavior Technician | 800 S Broadway Ste. 310, Walnut Creek, CA 94596 | 2019-02-06 |
| 1134683618 | Ian Colas | Respiratory Therapist, Certified | 1425 South Main Street, Walnut Creek, Walnut Creek, CA 94596 | 2019-01-29 |
| 1912474131 | Albert Dizon Miraflores | Behavior Technician | 1910 Olympic Blvd Walnut Creek Ca 94596, Walnut Creek, CA 94596 | 2018-10-25 |
| 1487136834 | Daryn Stier | Social Worker | 80 Norlyn Drive, Walnut Creek, CA 94596 | 2018-09-02 |
| 1831682335 | Jessica Lim | Registered Nurse | 1357 Oakland Blvd, Walnut Creek, CA 94596 | 2018-06-08 |
| 1699278432 | Alanna Everhart | Behavior Technician | 877 Ygnacio Valley Road, Suite 100, Walnut Creek, CA 94596 | 2018-03-16 |
| 1962958108 | Derek Jue Md | Clinic/Center | 1812 San Miguel Drive, Walnut Creek, CA 94596 | 2016-08-28 |
| 1912369711 | Pamela Jean Lister | Marriage & Family Therapist | 2070 N Broadway, #5370, Walnut Creek, CA 94596 | 2016-03-22 |
| 1548635147 | Anne Lamoreaux Anderson | Behavioral Analyst | 800 South Broadway Suite #310, Walnut Creek, CA 94596 | 2015-12-08 |
| 1346619434 | Christine Anne Gotelli | Registered Nurse | 370 N. Civic Drive #311, San Francico, CA 94596 | 2015-09-18 |
| Find all providers in zip 94596 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629192240 | Vincent Eugin Yamamoto | Orthopaedic Surgery | 1425 S Main St, Walnut Creek, CA 94596-5318 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316440563 | California Integrated Surgeons, Medical Corporation | Orthopaedic Surgery | 2750 Rohrer Dr, Lafayette, CA 94549-5753 | 2018-03-14 |
| 1457875023 | Adnan Cutuk, M.d. Inc. | Orthopaedic Surgery | 300 S Pierce St Ste 202, El Cajon, CA 92020-4124 | 2017-07-26 |
| 1932526555 | Mark Greenspan | Orthopaedic Surgery | 4955 Van Nuys Blvd Ste 704, Sherman Oaks, CA 91403-1819 | 2014-03-20 |
| 1548527864 | Philip Kiplinger | Orthopaedic Surgery | 19459 Shasta Rd, Apple Valley, CA 92307-4726 | 2012-04-12 |
| 1962778597 | Zachary Lum | Orthopaedic Surgery | Uc Davis Health - Department of Orthopaedic Surgery, 4860 Y Street, Suite 1700, Sacramento, CA 95817 | 2012-03-28 |
| 1508165721 | Michael Pitta | Orthopaedic Surgery | 12 Upper Ragsdale Dr Ste A, Monterey, CA 93940-5730 | 2011-03-28 |
| 1255638151 | Pier Francesco Indelli | Orthopaedic Surgery | 6841 Tunbridge Way, San Jose, CA 95120-2145 | 2011-02-12 |
| 1942510441 | Dilip Tapadiya M.d. Inc | Orthopaedic Surgery | 11170 Warner Ave Suite106, Fountain Valley, CA 92708 | 2010-10-18 |
| 1578886487 | Ricardo Alberto Moncho | Orthopaedic Surgery | 1417 Rutherford Dr, Pasadena, CA 91103-2775 | 2010-03-05 |
| 1598905382 | William Long, Md | Orthopaedic Surgery | 637 S. Lucas Ave. 1st Fl., Los Angeles, CA 90017 | 2009-03-06 |
| Find all providers with the same taxonomy | ||||
| City | WALNUT CREEK |
| Zip Code | 94596 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.