Healthcare Provider Details

I. General information

NPI: 1568311405
Provider Name (Legal Business Name): STEVEN DANIEL DONOGHUE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

5771 MIDDLECOFF DR
HUNTINGTON BEACH CA
92649-2764
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-7890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95038344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: