Individual
MICKEY AVRAM SEFFINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
795 E. SECOND ST., SUITE 5, POMONA, CA 91766-2007
(909) 865-2565
(909) 865-2955
Mailing address
795 E SECOND STREET, SUITE 5, POMONA, CA 91766-2007
(909) 865-2565
(909) 865-2955
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A5745
CA
207Q00000X
Family Medicine Physician
20A5745
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BZ219X
MEDICARE PTAN NO CA
CA
01
—
BZ219Z
MEDICARE PTAN SO CA
CA
Enumeration date
03/29/2007
Last updated
06/21/2012
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