Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stephanie Hackman, MD

Individual provider Body Imaging Physician · NPI 1770623209

Stephanie Hackman, MD is an Interventional Radiology in San Diego, California. Graduated from Rutgers New Jersey Medical School in 2000, 26 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
26
Trained at
Rutgers New Jersey Medical School
Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4647 Zion Ave
San Diego, CA 92120-2507
Phone: (619) 528-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Body Imaging Physician (primary) Taxonomy 2085B0100X · Licence A77103 (CA)

Record details

NPI number1770623209
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 7, 2007
Last updated in NPPESNovember 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL RADIOLOGY
Medical schoolRUTGERS NEW JERSEY MEDICAL SCHOOL
Graduated 2000 (26 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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