Provider Demographics
NPI:1285632604
Name:STEELE, STEPHEN ROSS (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROSS
Last Name:STEELE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45280 SEELEY DR
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-6834
Mailing Address - Country:US
Mailing Address - Phone:760-610-7300
Mailing Address - Fax:760-610-7301
Practice Address - Street 1:45280 SEELEY DR
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-6834
Practice Address - Country:US
Practice Address - Phone:760-610-7300
Practice Address - Fax:760-610-7301
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5555207QS0010X
CA5555207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A5555OtherSTATE LICENSE
CA205071093OtherTAX ID
CAF22713Medicare UPIN
CA20A5555OtherSTATE LICENSE