Healthcare Provider Details

I. General information

NPI: 1427121904
Provider Name (Legal Business Name): STEVEN L NELSON, M.D.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 N MAIN ST
YREKA CA
96097-2538
US

IV. Provider business mailing address

PO BOX 1066
YREKA CA
96097-1066
US

V. Phone/Fax

Practice location:
  • Phone: 530-842-1293
  • Fax: 530-842-4822
Mailing address:
  • Phone: 530-842-1293
  • Fax: 530-842-4822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: STEVEN L NELSON
Title or Position: PRESIDENT
Credential: MD
Phone: 530-842-1293