Healthcare Provider Details

I. General information

NPI: 1467563791
Provider Name (Legal Business Name): NORTH COUNTY TRAUMA ASSOCIATES, INC. A MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SOUTH HICKORY AVENUE SUITE 112
ESCONDIDO CA
92025-4360
US

IV. Provider business mailing address

2067 WINERIDGE PLACE SUITE A
ESCONDIDO CA
92029-1952
US

V. Phone/Fax

Practice location:
  • Phone: 760-489-5955
  • Fax: 760-489-7150
Mailing address:
  • Phone: 760-740-6944
  • Fax: 760-740-9619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: JOHN T. STEELE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 760-489-5955