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Individual

DR. CARL R SELIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
17400 IRVINE BLVD, SUITE F, TUSTIN, CA 92780-3030
(714) 838-5610
Mailing address
17400 IRVINE BLVD, SUITE F, TUSTIN, CA 92780-3030
(714) 838-5610

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A20803
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1437265352
NPI
CA
01
1689633125
GRP.NPI
CA
01
W1779
MEDICARE GRP #
CA
Enumeration date
08/22/2006
Last updated
02/21/2008
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