MEDICARE: DR. DONALD KENNETH STEENSMA O.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	152W00000X	Optometrist	OPT6121TPL	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1194748509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD KENNETH STEENSMA O.D.

Provider Business Mailing Address
First Line	:	465 W CHANNEL ISLANDS BLVD
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041-2102
Country	:	US
Telephone Number	:	805-486-3585
Fax Number	:	805-486-3586

Provider Business Practice Location Address
First Line	:	465 W CHANNEL ISLANDS BLVD
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041-2102
Country	:	US
Telephone Number	:	805-486-3585
Fax Number	:	805-486-3586

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	11/26/2008

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