Provider Demographics
NPI:1780627141
Name:ENG, STEVE MINH (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:MINH
Last Name:ENG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9093
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92728-9093
Mailing Address - Country:US
Mailing Address - Phone:714-843-3203
Mailing Address - Fax:
Practice Address - Street 1:18111 BROOKHURST ST # 3400
Practice Address - Street 2:#3400
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6728
Practice Address - Country:US
Practice Address - Phone:714-861-4630
Practice Address - Fax:714-861-4631
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4394213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E43940Medicaid
CAE4394Medicare ID - Type Unspecified
CA000E43940Medicaid