Steven Michael Deterville, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A33195 Issued in CA

Practice address

21634 Retreat Pkwy
Corona, CA 92883-6100

Phone

(951) 493-6810

Fax

(951) 826-8139

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Riverside Medical Clinic, Inc

  • Dermatology Physician
  • Riverside, CA
  • NPI 1720183403

  CA

  Medicare reassignment NPD
• Riverside Medical Clinic, Inc

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1730180415

  Pediatrics

  NPD
• Riverside Medical Clinic, Inc

  • Family Medicine Physician
  • Eastvale, CA
  • NPI 1972845535

  Pediatrics

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1700860285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6810",
            "fax_number": "951-826-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6810",
            "fax_number": "951-826-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETERVILLE",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A33195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SITE LOCATION NUMBER",
            "identifier": "ZZZ31887Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Subhash B Deshmukh, MD
• Suhasini Deshmukh, MD
• Falaya Desilva
• Mahesh Suranjan Desilva, M.D.
• Desouza Medical Group Inc
• Krista Dewindt
• Sheenum Dhiman
• Umadevi Dhulia
• Diana C Andrew
• Diane Boval DDS a Professional Dental Corp

• All providers in Corona, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.