Provider Demographics
NPI:1396382180
Name:DU, STEVEN T (PT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:T
Last Name:DU
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10411 DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3212
Mailing Address - Country:US
Mailing Address - Phone:714-696-4694
Mailing Address - Fax:
Practice Address - Street 1:10411 DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3212
Practice Address - Country:US
Practice Address - Phone:714-696-4694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist