Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1124216965 |
---|---|
Provider Name | Daniel H Selleck |
First Address | Newport Beach, CA 92663-3641 |
Second Address | Newport Beach, CA 92663-3641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2007 |
Last Update Date | 05/10/2007 |