Provider Demographics
NPI:1851328256
Name:KASPER, STEVE EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:EUGENE
Last Name:KASPER
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 1:1560 E CHEVY CHASE DR
Mailing Address - Street 2:SUITE 345
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4197
Mailing Address - Country:US
Mailing Address - Phone:818-696-1611
Mailing Address - Fax:818-696-1607
Practice Address - Street 1:1560 E CHEVY CHASE DR
Practice Address - Street 2:SUITE 345
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4197
Practice Address - Country:US
Practice Address - Phone:818-696-1611
Practice Address - Fax:818-696-1607
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG068579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE92220Medicare UPIN