MEDICARE: DOUGLAS L STEEL MD A PROFESSIONAL CORPORATION

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	261QA1903X	Ambulatory Surgical Clinic/Center		CA

General Provider Information

NPI Number	:	1073601001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS L STEEL MD A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	321 N LARCHMONT BLVD
Second Line	:	STE 1021
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-6410
Country	:	US
Telephone Number	:	323-466-7337
Fax Number	:	323-962-9753

Provider Business Practice Location Address
First Line	:	321 N LARCHMONT BLVD
Second Line	:	STE 1021
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-6410
Country	:	US
Telephone Number	:	323-466-7337
Fax Number	:	323-962-9753

Authorized Official
Title or Position	:	DIRECTOR OF SURGERY
Name	:	ALEXIS JACOBE
Credential	:
Telephone Number	:	805-987-5300

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/14/2012

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