Healthcare Provider Details

I. General information

NPI: 1215095963
Provider Name (Legal Business Name): LUNDI C SENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 W HERNDON AVE # 800-87
CLOVIS CA
93612-0191
US

IV. Provider business mailing address

605 W HERNDON AVE # 800-87
CLOVIS CA
93612-0191
US

V. Phone/Fax

Practice location:
  • Phone: 949-464-7654
  • Fax:
Mailing address:
  • Phone: 949-464-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA129327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: