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General NPI Number Information
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NPI Number | 1215734447
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Entity Type | Organization
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Legal Business Name | STEVEN LONG, MD
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 13282 TIBURON WAY
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City | TUSTIN
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State | CA
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Zip | 92782-8613
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Country | US
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Telephone | 714-357-6908
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Fax |
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Provider Business Mailing Address
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Address Line | 4870 BARRANCA PKWY STE 260
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City | IRVINE
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State | CA
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Zip | 92604-1700
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Country | US
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Telephone | 949-551-0300
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Fax | 949-551-0316
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN LONG
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Credential | MD
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Telephone | 949-551-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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