Provider Demographics
NPI:1841837903
Name:BEHM, STEVEN (DPT, PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BEHM
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 16TH PL APT C
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-9408
Mailing Address - Country:US
Mailing Address - Phone:616-443-7839
Mailing Address - Fax:
Practice Address - Street 1:12 MAUCHLY STE A
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2394
Practice Address - Country:US
Practice Address - Phone:949-552-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-06
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT297678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist