Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G10475 | CA |
NPI | 1033514906 |
---|---|
Provider Name | Dr. Joseph Siegel |
First Address | Huntington Beach, CA 92649-1877 |
Second Address | Huntington Beach, CA 92649-1877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 04/11/2014 |