Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E3856 | CA |
Y | 222Z00000X | Podiatrist | E3856 | CA |
N | 213ES0103X | Foot & Ankle Surgery | E3856 | CA |
N | 213ES0131X | Foot Surgery | E3856 | CA |
NPI | 1083627558 |
---|---|
Provider Name | Michael W. Seiberg |
First Address | Rancho Mirage, CA 92270-1059 |
Second Address | Rancho Mirage, CA 92270-3221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 14/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U42094 | (02) | CA |