Provider Demographics
NPI:1952029407
Name:LYBARGER, STEVEN EDWARD (RN)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:EDWARD
Last Name:LYBARGER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3665 RUFFIN RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1882
Mailing Address - Country:US
Mailing Address - Phone:858-299-6900
Mailing Address - Fax:858-227-6900
Practice Address - Street 1:3665 RUFFIN RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1855
Practice Address - Country:US
Practice Address - Phone:858-299-6900
Practice Address - Fax:858-227-9777
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1175286163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse