Individual ProviderStephanie EontaGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098(619) 532-6400PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Eonta does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1306207519Provider TypeIndividualFull NameEonta, StephanieCredentialDOGenderFemaleSole ProprietorYesEnumeration Date3/15/2016Last Updated11/23/2022Contact InformationPractice LocationPractice Address34800 Bob Wilson Dr, San Diego, CA 92134-1098Phone(619) 532-6400FaxUnlisted FaxMailing LocationMailing Address34800 Bob Wilson Dr, San Diego, CA 92134-1098PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicense0102205860VirginiaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer