Organization
QUYNH L SEBASTIAN MD A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QUYNH L SEBASTIAN M.D. (CEO)
(310) 917-4433
Entity
Organization
Contact information
Practice address
1260 15TH ST, SUITE 709, SANTA MONICA, CA 90404-1135
(310) 917-4433
(310) 917-4432
Mailing address
1260 15TH ST, SUITE 709, SANTA MONICA, CA 90404-1135
(310) 917-4433
(310) 917-4432
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A64443
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W18517
MEDICARE GROUP ID
CA
Enumeration date
10/03/2007
Last updated
10/03/2007
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