Provider Demographics
NPI:1932730884
Name:STEED, JEFFREY BERNARD II (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BERNARD
Last Name:STEED
Suffix:II
Gender:M
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 1:1415 LEDGESTONE LN
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-3566
Mailing Address - Country:US
Mailing Address - Phone:303-319-4705
Mailing Address - Fax:
Practice Address - Street 1:1415 LEDGESTONE LN
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-3566
Practice Address - Country:US
Practice Address - Phone:303-319-4705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA57689363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant