Provider Demographics
NPI:1336344696
Name:NIETO, STEVEN SOLOMAN (DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SOLOMAN
Last Name:NIETO
Suffix:
Gender:M
Credentials:DPT, OCS
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Other - Last Name:
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Mailing Address - Street 1:3191 MISSION INN AVE # B
Mailing Address - Street 2:OLD SPAGHETTI FACTORY BUILDING
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92507-4138
Mailing Address - Country:US
Mailing Address - Phone:951-684-2874
Mailing Address - Fax:951-684-2980
Practice Address - Street 1:3191 MISSION INN AVE STE B
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-4188
Practice Address - Country:US
Practice Address - Phone:951-376-2692
Practice Address - Fax:951-684-2980
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT28089225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT280890Medicare ID - Type UnspecifiedPHYSICAL THERAPIST