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NPI Code Detail

MEDICARE: DR. JENNIFER LYNNE STEVER D.O.

MEDICARE: DR. JENNIFER LYNNE STEVER D.O.
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
1207P00000XEmergency Medicine Physician243386NY
2207P00000XEmergency Medicine Physician02006872AIN
3207P00000XEmergency Medicine Physician20A10348CA

General Provider Information

NPI Number : 1689870818
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER LYNNE STEVER D.O.
Provider Business Mailing Address
First Line : 111 N SEPULVEDA BLVD STE 210
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6849
Country : US
Telephone Number : 310-379-2134
Fax Number :
Provider Business Practice Location Address
First Line : 111 N SEPULVEDA BLVD STE 210
Second Line :
City : MANHATTAN BEACH
State : CA
Zip : 90266-6849
Country : US
Telephone Number : 310-379-2134
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2007
Last Update Date : 08/15/2022

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