Steven J Blaut

Individual provider Active NPI Chiropractor · Morro Bay, CA

NPI 1124127782 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1124127782
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
13458 (CA)
Practice address
1052 Main St Ste B
Morro Bay, CA 93442-4004
Phone
(805) 772-4419
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
13458CAMDChiropractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13458 CA Yes

Addresses

Primary practice location

1052 Main St Ste B
Morro Bay, CA 93442-4004

Mailing address

2501 Koa Ave
Morro Bay, CA 93442-1707
Phone (805) 772-1467

Other providers in Morro Bay, CA

All providers in Morro Bay, CA · Chiropractor in California

Sources for this page

Verify at the official NPI Registry.