Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 278079 | NY |
N | 111NI0900X | Internist | 278079 | NY |
N | 207R00000X | Internist | A135857 | CA |
N | 111NI0900X | Internist | A135857 | CA |
Y | 207RC0200X | Critical Care Medicine | A135857 | CA |
N | 207RP1001X | Pulmonary Disease | 01080322A | IN |
N | 207RP1001X | Pulmonary Disease | A135857 | CA |
NPI | 1013206648 |
---|---|
Provider Name | Dr. Sean Dooley |
First Address | Santa Monica, CA 90404-2303 |
Second Address | Santa Monica, CA 90404-2303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 24/11/2020 |