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NPI Code Detail

MEDICARE: STEVE E. GRUER PA-C

MEDICARE: STEVE E. GRUER PA-C
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
1363AM0700XMedical Physician AssistantPA17102CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA17102OTHERCALICENSE NUMBER
21760526263OTHERCANPI
317704514945OTHERCANPI - GROUP

General Provider Information

NPI Number : 1760526263
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVE E. GRUER PA-C
Provider Business Mailing Address
First Line : 24671 MONROE AVE
Second Line : # 102
City : MURRIETA
State : CA
Zip : 92562-2527
Country : US
Telephone Number : 951-461-8143
Fax Number : 951-461-8547
Provider Business Practice Location Address
First Line : 24671 MONROE AVE
Second Line : # 102
City : MURRIETA
State : CA
Zip : 92562-2527
Country : US
Telephone Number : 951-461-8143
Fax Number : 951-461-8547
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 02/05/2016

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