Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 20A 7852 | CA |
NPI | 1063592277 |
---|---|
Provider Name | Dr. Sean Christopher Skelton |
First Address | La Mesa, CA 91942-3021 |
Second Address | La Mesa, CA 91942-3021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 06/03/2018 |