Provider Demographics
NPI:1184720112
Name:FIRME, STEVE RANDAL EJERCITO (MD)
Entity type:Individual
Prefix:DR
First Name:STEVE RANDAL
Middle Name:EJERCITO
Last Name:FIRME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:EJERCITO
Other - Last Name:FIRME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1719 N TULARE WAY
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1961
Mailing Address - Country:US
Mailing Address - Phone:909-949-8960
Mailing Address - Fax:
Practice Address - Street 1:980 E FOOTHILL BLVD STE 102
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4068
Practice Address - Country:US
Practice Address - Phone:909-981-5738
Practice Address - Fax:909-981-4577
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-056921-L208000000X
FLME83197208000000X
CAA056129208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG95824Medicare UPIN