Healthcare Provider Details

I. General information

NPI: 1821167610
Provider Name (Legal Business Name): STEVEN LEE KATZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 06/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD SUITE 309
MILL VALLEY CA
94941-3034
US

IV. Provider business mailing address

455 STATE RD PMB 133
VINEYARD HAVEN MA
02568-5695
US

V. Phone/Fax

Practice location:
  • Phone: 415-381-3838
  • Fax: 415-381-9366
Mailing address:
  • Phone: 508-696-1863
  • Fax: 508-696-1862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number12725
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: