MEDICARE: STEVEN DALE BLAIR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A70395	CA

General Provider Information

NPI Number	:	1043313257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN DALE BLAIR M.D.

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD
Second Line	:	SUITE 100
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	866-681-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	1590 POOLE BLVD
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95993-2607
Country	:	US
Telephone Number	:	530-751-1800
Fax Number	:	530-751-3901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	06/02/2015

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