STEVEN MICHAEL DETERVILLE (NPI# 1700860285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700860285 |
| Entity Type | Individual |
| Full Name | STEVEN MICHAEL DETERVILLE |
| Credential | MD |
| Practice Address |
21634 Retreat Pkwy Corona CA 92883-6100 |
| Mailing Address |
3660 Arlington Ave Riverside CA 92506-3912 |
| Practice Telephone | 9514936810 |
| Mailing Telephone | 9514936810 |
| Mailing Fax Number | 9514936814 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A33195 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SITE LOCATION NUMBER | ZZZ31887Z | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 830 Magnolia Ave, Corona, CA 928793128 | 9514936810 | 9514936814 |
| Street Address |
21634 RETREAT PKWY |
| City | CORONA |
| State | CA |
| Zip Code | 92883-6100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124025598 | Michael T. Mai | Orthopaedic Surgery | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2005-06-30 |
| 1013561810 | Riverside Medical Clinic, Inc | Family Medicine | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2019-07-30 |
| 1760043426 | Rmc Surgery Center Inc | Clinic/Center | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2019-06-24 |
| 1053775684 | Alexander James Geyer | Student in an Organized Health Care Education/Training Program | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2016-04-10 |
| 1043688633 | Misbah Patel Rasool | Family Medicine | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2015-09-13 |
| 1609257435 | Poyrung Poysophon | Family Medicine | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2015-06-17 |
| 1578976270 | Iwan Nyotowidjojo | Internal Medicine | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2014-06-10 |
| 1851719512 | Samarjeet Bajwa | Psychiatry & Neurology | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2014-03-31 |
| 1164783908 | Simran Brar | Internal Medicine | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2012-06-07 |
| 1750647418 | Pejman Solaimani | Student in an Organized Health Care Education/Training Program | 21634 Retreat Pkwy, Corona, CA 92883-6100 | 2012-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496815 | Onyinye Yvonne Johnson | Nurse Practitioner | 27223 Lasso Way, Corona, CA 92883 | 2017-09-21 |
| 1215376850 | Jennifer Carol Bard | Speech-Language Pathologist | 4194 Floyd Drive, Corona, CA 92883 | 2013-06-17 |
| 1023359619 | Richard Joon Kim | Pharmacist | 4315 Driving Range Rd, Corona, CA 92883 | 2013-03-07 |
| 1740590330 | Kim-thoa Thi Vu | Pharmacist | 2243 Eagle Glen Parkway, Corona, CA 92883 | 2010-10-15 |
| 1114232154 | Always 'tfy' Hospice, Inc. | Hospice Care, Community Based | 9064 Pulsar Court, Ste E, Corona, CA 92883 | 2010-08-14 |
| 1952553844 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 11950 Depalma Rd, Corona, CA 92883 | 2008-10-22 |
| 1497979280 | Sang C Paik Dds | Dentist | 3811 Bedford Canyon Rd, Suite 105, Corona, CA 92883 | 2007-04-12 |
| 1285615864 | Mallory Leon | Family Medicine | 25085 Pacific Crest Street, Corona, CA 92883 | 2005-11-09 |
| 1326038993 | Chan Woo Lee | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2005-10-25 |
| 1659575736 | Optique Optometry, A Professional Corporation | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2007-06-13 |
| Find all providers in zip 92883 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770863953 | Hispaniola Pediatrics PC | Pediatrics | 4048 Junction Blvd, First Floor, Corona, NY 11368-2206 | 2011-08-19 |
| 1396912887 | Ingrid Williams | Pediatrics | 3758 108th St, Corona, NY 11368-2023 | 2008-05-13 |
| 1427233667 | Abc Medical Group, Inc,, Apc | Pediatrics | 650 E Parkridge Ave, Suitte 114 & 115, Corona, CA 92879-1091 | 2008-01-07 |
| 1770799215 | Maria Quezada | Pediatrics | 102 11 Roosevelt Ave., Corona, NY 11368-2331 | 2007-05-14 |
| 1285850974 | Elena B Jackson | Pediatrics | 770 Magnolia Ave Suite 2a, Corona, CA 92879-3122 | 2007-04-18 |
| 1275657793 | Mario Saint Laurent | Pediatrics | 3765 104th St, Corona, NY 11368-1947 | 2007-03-19 |
| 1649337858 | Hector Bienvenido Florimon De La Rosa | Pediatrics | 102-11 Roosevelt Ave, Corona, NY 11368 | 2007-01-03 |
| 1821160821 | Tannaz Ghassemi Hild | Pediatrics | 3971 Ashwood Cir, Corona, CA 92881-8820 | 2006-11-14 |
| 1114011780 | Ganesh Karim Md | Pediatrics | 97-30 57th Ave., Suite 1k, Corona, NY 11368 | 2006-10-03 |
| 1417040361 | Yvonne Ramona D'sylva | Pediatrics | 770 Magnolia Ave Ste 2a, Corona, CA 92879-3122 | 2006-10-02 |
| Find all providers in CORONA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.