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General NPI Number Information
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NPI Number | 1962603993
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Entity Type | Individual
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Provider Name | STEVEN ROBERT NOAKES PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NAVAL MEDICAL CENTER SAN DIEGO 34101 FARENHOLT AVE
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City | SAN DIEGO
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State | CA
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Zip | 92134
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Country | US
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Telephone | 619-524-5205
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Fax |
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Provider Business Mailing Address
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Address Line | 10936 CAMINITO ALTO
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City | SAN DIEGO
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State | CA
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Zip | 92131-3556
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Country | US
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Telephone | 619-855-0768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | NCCPA # 1046078
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License Number State | GA
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