MEDICARE: STEVEN TRADONSKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	A53852	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W1762	OTHER	CA	MEDICARE GROUP
2	WA53852B	OTHER	CA	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013910900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN TRADONSKY M.D.

Provider Business Mailing Address
First Line	:	5643 COPLEY DR STE 300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-7903
Country	:	US
Telephone Number	:	858-455-9942
Fax Number	:	858-455-6473

Provider Business Practice Location Address
First Line	:	5643 COPLEY DR STE 300
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-7903
Country	:	US
Telephone Number	:	858-455-9942
Fax Number	:	858-455-6473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/01/2025

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Directions to “ STEVEN TRADONSKY M.D.” Practice Location

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