STEPHEN NORFLEET ETHEREDGE MD NPI 1770694101

NPI Information

  • NPI: 1770694101
  • Provider Name: STEPHEN NORFLEET ETHEREDGE, MD
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • Address: 365 HAWTHORNE AVE
    STE 103
    OAKLAND, CA
    ZIP 94609
  • Phone: (510) 832-6131

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NPI Details

Stephen Norfleet Etheredge, MD is a vascular surgery surgery in Oakland, CA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Stephen Norfleet Etheredge, MD NPI is 1770694101. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

365 HAWTHORNE AVE
STE 103
OAKLAND, CA
ZIP 94609-107
Phone: (510) 832-6131

The enumeration date for this NPI number is 8/31/2006 and was last updated on 5/21/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryC38647CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1230000724MEDICARE PINCALIFORNIA
200C386470MEDICAIDCALIFORNIA
300C386470MEDICARE PINCALIFORNIA
4A36974MEDICARE UPINCALIFORNIA
5760000205MEDICARE PINCALIFORNIA
600C386472MEDICARE PINCALIFORNIA
700C386471MEDICARE PINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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