Provider Demographics
NPI:1922239979
Name:KIEFER, STEVEN G (CO)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:G
Last Name:KIEFER
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 PARKRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-3124
Mailing Address - Country:US
Mailing Address - Phone:951-734-1835
Mailing Address - Fax:951-734-1538
Practice Address - Street 1:41707 WINCHESTER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4867
Practice Address - Country:US
Practice Address - Phone:951-296-1894
Practice Address - Fax:951-296-1896
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO003477174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist