Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 49809 | CA |
NPI | 1083789309 |
---|---|
Provider Name | Douglas S Szeto |
First Address | Lake Forest, CA 92630 |
Second Address | Lake Forest, CA 92630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 16/08/2013 |