Provider Demographics
NPI:1821026063
Name:MARON, STEVEN PETER (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PETER
Last Name:MARON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:PETER
Other - Last Name:MARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 662110
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91066-2110
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:301 E 13TH ST
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-6211
Practice Address - Country:US
Practice Address - Phone:209-385-7111
Practice Address - Fax:209-385-7066
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64122207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G641220Medicaid
CA00G641229Medicare PIN
CA0G6412212Medicare PIN
CA0G6412215Medicare PIN
CA0G6412200Medicare PIN
CA00G6412214Medicare PIN
CA0G6412211Medicare PIN
CA0G6412202Medicare PIN
CAAO039ZMedicare PIN
CA0G6412216Medicare PIN
CA0G6412217Medicare PIN
CA00G641223Medicare PIN
CAF17535Medicare UPIN
CA00G641228Medicare PIN