Provider Demographics
NPI:1932266715
Name:STEINEKE, SUSAN GWEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:GWEN
Last Name:STEINEKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27400 HESPERIAN BLVD
Mailing Address - Street 2:GENERAL SURGERY DEPARTMENT
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4235
Mailing Address - Country:US
Mailing Address - Phone:510-784-2878
Mailing Address - Fax:
Practice Address - Street 1:27400 HESPERIAN BLVD
Practice Address - Street 2:GENERAL SURGERY DEPARTMENT
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4235
Practice Address - Country:US
Practice Address - Phone:510-784-2878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14853363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical