Provider Demographics
NPI:1295760221
Name:APPLEBAUM, STEVEN HERSCH (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:HERSCH
Last Name:APPLEBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 S FAIR OAKS AVE STE 320
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2674
Practice Address - Country:US
Practice Address - Phone:626-396-2999
Practice Address - Fax:626-396-2991
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72790207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G727900Medicaid
CAG30598Medicare UPIN
CAWG72790HMedicare PIN
CAWG72790IMedicare PIN