Healthcare Provider Details

I. General information

NPI: 1831202969
Provider Name (Legal Business Name): KIM STEFFES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CONSTANCE KIM MARTYNUIK

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19829 N 27TH AVE
PHOENIX AZ
85027-4001
US

IV. Provider business mailing address

3916 STATE ST SUITE 300
SANTA BARBARA CA
93105-5602
US

V. Phone/Fax

Practice location:
  • Phone: 623-879-6100
  • Fax:
Mailing address:
  • Phone: 805-563-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25574
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: