Provider Demographics
NPI:1386716934
Name:ORNISH, STEVEN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:ORNISH
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 1:591 CAMINO DE LA REINA STE 820
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3110
Mailing Address - Country:US
Mailing Address - Phone:619-692-3222
Mailing Address - Fax:
Practice Address - Street 1:591 CAMINO DE LA REINA STE 820
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3110
Practice Address - Country:US
Practice Address - Phone:619-692-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC417332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry