Provider Demographics
NPI:1508041898
Name:WALNUT CREEK MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:WALNUT CREEK MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-963-0888
Mailing Address - Street 1:1779 N UNIVERSITY DR
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-0929
Mailing Address - Country:US
Mailing Address - Phone:954-963-0888
Mailing Address - Fax:954-985-9818
Practice Address - Street 1:1779 N UNIVERSITY DR
Practice Address - Street 2:SUITE #101
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-0929
Practice Address - Country:US
Practice Address - Phone:954-963-0888
Practice Address - Fax:954-985-9818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherHUMANA