Organization
STEVEN P. BLEIWEISS MD, INC
Active
Other names
Kennedy Surgical Pathology Medical Associates, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN P BLEIWEISS (MD/PRESIDENT)
(909) 881-6711
Entity
Organization
Contact information
Practice address
2101 WATERMAN, SAN BERNARDINO, CA 92404
(909) 881-4522
Mailing address
P.O. BOX 6015-0015, CYPRESS, CA 90630-0015
(714) 236-4000
(714) 236-4006
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G20642
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0088961
—
CA
01
—
ZZZ02881Z
BLUE SHIELD
CA
Enumeration date
11/07/2006
Last updated
07/29/2008
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