Provider Demographics
NPI:1619997624
Name:HOROWITZ, STEVEN ERIC (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ERIC
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3089 CLAIREMONT DR STE C
Mailing Address - Street 2:#338
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-6892
Mailing Address - Country:US
Mailing Address - Phone:619-442-5400
Mailing Address - Fax:619-285-9791
Practice Address - Street 1:161 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3909
Practice Address - Country:US
Practice Address - Phone:619-442-5400
Practice Address - Fax:619-285-9791
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A4926207Q00000X
CA2OA4926208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAX49260Medicaid
CAW20A4926AMedicare ID - Type Unspecified
CAAX49260Medicaid