Healthcare Provider Details

I. General information

NPI: 1407915150
Provider Name (Legal Business Name): STEVEN A. VASILEV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 TRAFFIC WAY
ARROYO GRANDE CA
93420-3376
US

IV. Provider business mailing address

154 TRAFFIC WAY
ARROYO GRANDE CA
93420-3376
US

V. Phone/Fax

Practice location:
  • Phone: 424-255-1340
  • Fax: 805-935-4338
Mailing address:
  • Phone: 424-255-1340
  • Fax: 805-935-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberG56061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: