Basic Information
Provider Information
NPI: 1407852783
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEINBERG
FirstName: STEVEN
MiddleName: M.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9610 GRANITE RIDGE DR
Address2: STE B
City: SAN DIEGO
State: CA
PostalCode: 921232684
CountryCode: US
TelephoneNumber: 8588108000
FaxNumber: 8582681911
Practice Location
Address1: 7910 FROST ST
Address2: STE 220
City: SAN DIEGO
State: CA
PostalCode: 921232771
CountryCode: US
TelephoneNumber: 8586374700
FaxNumber: 8586374701
Other Information
ProviderEnumerationDate: 06/22/2005
LastUpdateDate: 09/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300XG17843CAY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

ID Information
IDTypeStateIssuerDescription
00G17843005CA MEDICAID


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