Provider Demographics
NPI:1700811775
Name:ELSEA, STEVEN WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:ELSEA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 WILLIAM WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2020
Mailing Address - Country:US
Mailing Address - Phone:916-784-3303
Mailing Address - Fax:866-350-6202
Practice Address - Street 1:605 OAK ST
Practice Address - Street 2:SUITE B
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3224
Practice Address - Country:US
Practice Address - Phone:916-784-3303
Practice Address - Fax:866-350-6202
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT97405Medicare UPIN
CADC0180850Medicare ID - Type Unspecified