Provider Demographics
NPI:1497497267
Name:MCLEOD, STEVEN ANDREW
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ANDREW
Last Name:MCLEOD
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 1:11884 ALBION WAY
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-6172
Mailing Address - Country:US
Mailing Address - Phone:944-306-9617
Mailing Address - Fax:
Practice Address - Street 1:14252 SCHLEISMAN RD STE 203
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:92880-4026
Practice Address - Country:US
Practice Address - Phone:951-460-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA10245225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant