Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC28023 | CA |
N | 111NI0013X | Independent Medical Examiner | DC28023 | CA |
NPI | 1619197209 |
---|---|
Provider Name | Stephen A Stepaniuk |
First Address | Culver City, CA 90232-3196 |
Second Address | Lawndale, CA 90260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 27/01/2014 |