Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G29912 | CA |
N | 111NI0900X | Internist | G29912 | CA |
Y | 207U00000X | Nuclear Medicine Specialist | G29912 | CA |
NPI | 1679506018 |
---|---|
Provider Name | John S Seder |
First Address | Santa Barbara, CA 93105-5322 |
Second Address | Ventura, CA 93003-2809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 07/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005299121 | (05) | CA |
00G29912 0 | BS OF CA (01) | CA |
00G299120 | BLUE SHIELD (01) | CA |
00G299121 | (05) | CA |
1679506018 | (05) | CA |