Individual ProviderJerome StenehjemSpecialistOther Service ProvidersPractice Address8765 Aero Dr Ste 310, San Diego, CA 92123-1767(858) 541-4480PECOS EnrollmentBased on the most recent information from CMS, provider Jerome Stenehjem is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1790992279Provider TypeIndividualFull NameStenehjem, JeromeTitleDr.CredentialM.D.GenderMaleSole ProprietorYesEnumeration Date5/16/2007Last Updated6/21/2022Contact InformationPractice LocationPractice Address8765 Aero Dr Ste 310, San Diego, CA 92123-1767Phone(858) 541-4480Fax(858) 541-4452Mailing LocationMailing Address8765 Aero Dr Ste 310, San Diego, CA 92123-1767Phone(858) 541-4480Fax(858) 541-4452Provider TaxonomiesCodeDescriptionLicenseCode174400000XPrimaryDescriptionSpecialistOther Service ProvidersLicenseG55883CaliforniaProvider IdentifiersIDDescriptionIssuerID4401818DescriptionMedicaidIssuerUnlistedCalifornia