Provider Demographics
NPI:1760526263
Name:GRUER, STEVE E (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:E
Last Name:GRUER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24671 MONROE AVE
Mailing Address - Street 2:# 102
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-2527
Mailing Address - Country:US
Mailing Address - Phone:951-461-8143
Mailing Address - Fax:951-461-8547
Practice Address - Street 1:24671 MONROE AVE
Practice Address - Street 2:# 102
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-2527
Practice Address - Country:US
Practice Address - Phone:951-461-8143
Practice Address - Fax:951-461-8547
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17102363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA17102OtherLICENSE NUMBER
CA1760526263OtherNPI
CA17704514945OtherNPI - GROUP
CAWPA17102AMedicare PIN
CAPA17102OtherLICENSE NUMBER
CA1760526263OtherNPI
CA17704514945OtherNPI - GROUP