Healthcare Provider Details

I. General information

NPI: 1255430898
Provider Name (Legal Business Name): STEVEN R. UZELAC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 SUNRISE BL
CITRUS HEIGHTS CA
95610-3011
US

IV. Provider business mailing address

200 OCEANGATE #100
LONG BEACH CA
90802-4317
US

V. Phone/Fax

Practice location:
  • Phone: 916-722-2227
  • Fax: 916-723-0142
Mailing address:
  • Phone: 562-499-6191
  • Fax: 562-499-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA54698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: