Provider Demographics
NPI:1942356795
Name:PLAXE, STEVEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:PLAXE
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 1:200 WEST ARBOR DRIVE
Mailing Address - Street 2:MC 8201
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8201
Mailing Address - Country:US
Mailing Address - Phone:858-657-8745
Mailing Address - Fax:858-657-8666
Practice Address - Street 1:200 WEST ARBOR DRIVE
Practice Address - Street 2:MC 8201
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-8201
Practice Address - Country:US
Practice Address - Phone:858-657-8745
Practice Address - Fax:858-657-8666
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64817207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G648170Medicaid
CA00G648170Medicaid
CAWG64817AMedicare PIN