Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO03451 | |
N | 222Z00000X | Podiatrist | CPO03451 | |
Y | 224P00000X | Prosthetist | CPO03451 |
NPI | 1295306496 |
---|---|
Provider Name | Steven Metzbrown |
First Address | Trabuco Canyon, CA 92679-5329 |
Second Address | Laguna Hills, CA 92653-3616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2021 |
Last Update Date | 08/07/2021 |