Healthcare Provider Details

I. General information

NPI: 1053589408
Provider Name (Legal Business Name): DAVID R. STERLING, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2342 PROFESSIONAL PKWY SUITE 100
SANTA MARIA CA
93455-1630
US

IV. Provider business mailing address

2342 PROFESSIONAL PKWY SUITE 100
SANTA MARIA CA
93455-1630
US

V. Phone/Fax

Practice location:
  • Phone: 805-928-5645
  • Fax: 805-739-1186
Mailing address:
  • Phone: 805-928-5645
  • Fax: 805-738-1186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2745
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCA

VIII. Authorized Official

Name: JACQUE STERLING
Title or Position: EXECUTIVE DIRECTOR OFFICER
Credential:
Phone: 805-928-5645