Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G85344 | CA |
N | 207RI0011X | Interventional Cardiology | G85344 | CA |
NPI | 1023059763 |
---|---|
Provider Name | Dr. Steven T. Forman |
First Address | Los Alamitos, CA 90720-2808 |
Second Address | Los Alamitos, CA 90720-2808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 07/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G853440 | (05) | CA |
G42196 | (02) |