Healthcare Provider Details

I. General information

NPI: 1063241958
Provider Name (Legal Business Name): MICHAEL A STEA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 CARNEGIE AVE STE 1C
SANTA ANA CA
92705-5504
US

IV. Provider business mailing address

PO BOX 632
LOS ALAMITOS CA
90720-0632
US

V. Phone/Fax

Practice location:
  • Phone: 800-273-4292
  • Fax:
Mailing address:
  • Phone: 949-210-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: