Provider Demographics
NPI:1912712316
Name:ZEIGLER, STEPHEN ALAIN
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ALAIN
Last Name:ZEIGLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 N TOWNE AVE APT 23
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2060
Mailing Address - Country:US
Mailing Address - Phone:909-367-1918
Mailing Address - Fax:
Practice Address - Street 1:599 INLAND CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1843
Practice Address - Country:US
Practice Address - Phone:909-915-2041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53874225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant