Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | G41617 | CA |
NPI | 1013151000 |
---|---|
Provider Name | Dr. John Moss Seelig |
First Address | San Diego, CA 92122 |
Second Address | San Diego, CA 92122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 27/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48633 | (02) | CA |