Provider Demographics
NPI:1295809796
Name:STRUCK, STEVEN K (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:STRUCK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3301 EL CAMINO REAL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-3812
Mailing Address - Country:US
Mailing Address - Phone:650-562-0587
Mailing Address - Fax:650-562-0581
Practice Address - Street 1:3301 EL CAMINO REAL
Practice Address - Street 2:SUITE 200
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-3812
Practice Address - Country:US
Practice Address - Phone:650-562-0587
Practice Address - Fax:650-562-0581
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG76521208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery