Provider Demographics
NPI:1871566364
Name:MENDELSOHN, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:MENDELSOHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 COURT ST
Mailing Address - Street 2:#203
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1830
Mailing Address - Country:US
Mailing Address - Phone:530-605-4081
Mailing Address - Fax:530-605-4083
Practice Address - Street 1:1950 COURT ST
Practice Address - Street 2:#203
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1830
Practice Address - Country:US
Practice Address - Phone:530-605-4081
Practice Address - Fax:530-605-4083
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO31322207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44723Medicare UPIN