Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YP0228X | Pediatric Otolaryngology | A44368 | CA |
NPI | 1457307761 |
---|---|
Provider Name | Marc A Seftel |
First Address | Santa Cruz, CA 95060-4126 |
Second Address | Santa Cruz, CA 95060-4126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 25/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A443680 | (05) | CA |
E89172 | (02) | CA |