Provider Demographics
NPI:1720079924
Name:DARMAWAN, STEVE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:
Last Name:DARMAWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ABBOTT ST STE C
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4486
Mailing Address - Country:US
Mailing Address - Phone:831-288-8811
Mailing Address - Fax:831-998-7809
Practice Address - Street 1:333 ABBOTT ST STE C
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4486
Practice Address - Country:US
Practice Address - Phone:831-288-8811
Practice Address - Fax:831-998-7809
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85492208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11496065OtherCAQH
CA176005001Medicaid