Provider Demographics
NPI:1346556263
Name:SANDERS, STEVEN JAMES (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:SANDERS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17095 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-0000
Mailing Address - Country:US
Mailing Address - Phone:760-241-6666
Mailing Address - Fax:760-956-4156
Practice Address - Street 1:1310 SAN BERNARDINO RD STE 105
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4985
Practice Address - Country:US
Practice Address - Phone:909-429-2864
Practice Address - Fax:909-429-2868
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21125363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical