Provider Demographics
NPI:1396864120
Name:HART, STEVEN JAMES
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:JAMES
Last Name:HART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9559 COTTONWOOD AVE
Mailing Address - Street 2:F
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-6710
Mailing Address - Country:US
Mailing Address - Phone:619-515-6615
Mailing Address - Fax:619-515-6644
Practice Address - Street 1:9559 COTTONWOOD AVE
Practice Address - Street 2:F
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-6710
Practice Address - Country:US
Practice Address - Phone:619-515-6615
Practice Address - Fax:619-515-6644
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator