Healthcare Provider Details

I. General information

NPI: 1114231446
Provider Name (Legal Business Name): DEAN S STEINBERGER OD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12214 VENTURA BLVD
STUDIO CITY CA
91604-2518
US

IV. Provider business mailing address

12214 VENTURA BLVD
STUDIO CITY CA
91604-2518
US

V. Phone/Fax

Practice location:
  • Phone: 818-761-3379
  • Fax: 818-530-7761
Mailing address:
  • Phone: 818-761-3379
  • Fax: 818-530-7761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number11289T
License Number StateCA

VIII. Authorized Official

Name: DR. DEAN SCOTT STEINBERGER
Title or Position: OPTOMETRISTS
Credential: OD
Phone: 818-761-3379