Individual
STEVEN C PONTIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.C.
Contact information
Practice address
1941 JOHNSON AVE, STE 101, SAN LUIS OBISPO, CA 93401
(805) 782-8844
(805) 782-8859
Mailing address
1941 JOHNSON AVE, STE 101, SAN LUIS OBISPO, CA 93401
(805) 782-8844
(805) 782-8859
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31700218
CA
207RC0000X
Cardiovascular Disease Physician
Primary
G23388
CA
207UN0901X
Nuclear Cardiology Physician
G23388
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G233880
—
CA
01
—
060007756
RAILROAD MEDICARE
CA
01
—
ZZZ24859Z
BLUE SHIELD
CA
Enumeration date
01/11/2006
Last updated
10/16/2013
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