Provider Demographics
NPI:1548298060
Name:STEELE, JAMES MARCO (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MARCO
Last Name:STEELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3536 MENDOCINO AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3634
Mailing Address - Country:US
Mailing Address - Phone:707-575-6049
Mailing Address - Fax:707-525-3791
Practice Address - Street 1:3867 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-5244
Practice Address - Country:US
Practice Address - Phone:707-525-3786
Practice Address - Fax:707-525-3791
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG50248207RP1001X, 207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00934767OtherRAILROAD MEDICARE
CA00G502480Medicaid
CA1548298060Medicaid
CA00G502480Medicaid
CA00G502480Medicare PIN
E57841Medicare UPIN