Provider Demographics
NPI:1407044050
Name:STEIJN, MILAN (PT)
Entity Type:Individual
Prefix:MR
First Name:MILAN
Middle Name:
Last Name:STEIJN
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 1:1178 N TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6006
Mailing Address - Country:US
Mailing Address - Phone:949-412-4913
Mailing Address - Fax:714-544-5570
Practice Address - Street 1:1178 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-6006
Practice Address - Country:US
Practice Address - Phone:949-412-4913
Practice Address - Fax:714-544-5570
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT18163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT18163BMedicare PIN