Organization
TADD L SELBY MD ADULT & PEDIATRIC UROLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TADD L SELBY MD (PRESIDENT)
(530) 893-0771
Entity
Organization
Contact information
Practice address
1166 ESPLANADE, SUITE 3, CHICO, CA 95926-3360
(530) 898-1201
(530) 893-1939
Mailing address
1166 ESPLANADE, SUITE 3, CHICO, CA 95926-3360
(530) 893-0771
(530) 893-1939
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G79258
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DQ8534
MEDICARE RAILROAD PTAN
CA
05
—
PENDING
—
CA
Enumeration date
02/22/2010
Last updated
09/19/2019
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