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Individual

SEAN PETER DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
13 VIA PACIFICA, SAN CLEMENTE, CA 92673-3910
(949) 374-2960
Mailing address
13 VIA PACIFICA, SAN CLEMENTE, CA 92673-3910
(949) 374-2960

Taxonomy

Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
556064
CA

Other

Enumeration date
03/22/2009
Last updated
03/22/2009
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