Provider Demographics
NPI:1952304842
Name:PRAGER, STEVEN SHERMAN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:SHERMAN
Last Name:PRAGER
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 1:45 E SAN JOAQUIN ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-2903
Mailing Address - Country:US
Mailing Address - Phone:831-424-3300
Mailing Address - Fax:831-758-4094
Practice Address - Street 1:45 E SAN JOAQUIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2903
Practice Address - Country:US
Practice Address - Phone:831-424-3300
Practice Address - Fax:831-758-4094
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG72539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0071130Medicaid
CAZZZ19547ZOtherMEDICARE GROUP NUMBER
CAGR0071130Medicaid
CAZZZ19547ZOtherMEDICARE GROUP NUMBER