Provider Demographics
NPI:1063600757
Name:CHARLES P STEINMANN MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:CHARLES P STEINMANN MD A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:P
Authorized Official - Last Name:STEINMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:939-675-2147
Mailing Address - Street 1:PO BOX 1966
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-0966
Mailing Address - Country:US
Mailing Address - Phone:949-675-2147
Mailing Address - Fax:949-675-2148
Practice Address - Street 1:1901 NEWPORT BLVD
Practice Address - Street 2:120
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-2278
Practice Address - Country:US
Practice Address - Phone:949-675-2147
Practice Address - Fax:949-675-2148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24786207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24135Medicare UPIN
CAW17286Medicare PIN