Basic Information
Provider Information
NPI: 1588760185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PALMER
FirstName: STEVEN
MiddleName: L.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 305 EAST CENTER AVE.
Address2:  
City: VISALIA
State: CA
PostalCode: 932916331
CountryCode: US
TelephoneNumber: 5597374700
FaxNumber: 5597374782
Practice Location
Address1: 501 NORTH BRIDGE STREET
Address2:  
City: VISALIA
State: CA
PostalCode: 932915034
CountryCode: US
TelephoneNumber: 5597341939
FaxNumber: 5597344384
Other Information
ProviderEnumerationDate: 09/15/2006
LastUpdateDate: 06/14/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XG85814CAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
00G85814005CA MEDICAID


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