Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | E5502 | CA |
N | 213ES0103X | Foot & Ankle Surgery | 6508 | NY |
NPI | 1164656914 |
---|---|
Provider Name | Steven Ea |
First Address | San Leandro, CA 94577-5147 |
Second Address | San Leandro, CA 94577-5147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2009 |
Last Update Date | 11/10/2019 |