Provider Demographics
NPI:1720187800
Name:EPNER, STEVEN LLOYD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LLOYD
Last Name:EPNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3156 VISTA WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-3622
Mailing Address - Country:US
Mailing Address - Phone:760-547-8084
Mailing Address - Fax:760-547-8085
Practice Address - Street 1:4002 VISTA WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4506
Practice Address - Country:US
Practice Address - Phone:760-940-4055
Practice Address - Fax:760-940-4084
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG789072085R0202X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G789070Medicaid
CAG26209Medicare UPIN
CAWG78907AMedicare ID - Type Unspecified