Provider Demographics
NPI:1558196337
Name:WIESELTIER, STEIGERWALD, PAL, INC
Entity type:Organization
Organization Name:WIESELTIER, STEIGERWALD, PAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER, CNO
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:STEIGERWALD
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:619-738-0881
Mailing Address - Street 1:PO BOX 2098
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91943-2098
Mailing Address - Country:US
Mailing Address - Phone:619-738-0881
Mailing Address - Fax:
Practice Address - Street 1:3252 HOLIDAY CT STE 204
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1808
Practice Address - Country:US
Practice Address - Phone:619-738-0881
Practice Address - Fax:619-354-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty