Individual
MR. BRENT MICHAEL SELDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Mailing address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
56311
CA
363A00000X
Physician Assistant
PA9105832
FL
Other
Enumeration date
02/25/2011
Last updated
12/05/2022
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