Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 41217 | CA |
NPI | 1144392457 |
---|---|
Provider Name | Dr. Jon Eric Steffensen |
First Address | Napa, CA 94558-3308 |
Second Address | Napa, CA 94558-3308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |