Provider Demographics
NPI:1821074063
Name:WESTERN, STEVEN (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:WESTERN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1100 N PALM CANYON DR
Mailing Address - Street 2:STE 110
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4418
Mailing Address - Country:US
Mailing Address - Phone:760-320-1199
Mailing Address - Fax:760-323-2769
Practice Address - Street 1:555 E TACHEVAH DR
Practice Address - Street 2:STE 3W105
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-5750
Practice Address - Country:US
Practice Address - Phone:760-320-1199
Practice Address - Fax:760-323-2769
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2020-03-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7125208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A7125AMedicare ID - Type Unspecified