Healthcare Provider Details

I. General information

NPI: 1720079924
Provider Name (Legal Business Name): STEVE DARMAWAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ABBOTT ST STE C
SALINAS CA
93901-4486
US

IV. Provider business mailing address

333 ABBOTT ST STE C
SALINAS CA
93901-4486
US

V. Phone/Fax

Practice location:
  • Phone: 831-288-8811
  • Fax: 831-998-7809
Mailing address:
  • Phone: 831-288-8811
  • Fax: 831-998-7809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: