Provider Demographics
NPI:1346523016
Name:SEMAK, STEVE ROSS (LAC)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:ROSS
Last Name:SEMAK
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534 YSRELLA AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3635
Mailing Address - Country:US
Mailing Address - Phone:805-587-9712
Mailing Address - Fax:
Practice Address - Street 1:1534 YSRELLA AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3635
Practice Address - Country:US
Practice Address - Phone:805-587-9712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8365171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist