Healthcare Provider Details

I. General information

NPI: 1811047970
Provider Name (Legal Business Name): CLARA M SEAL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N STATE COLLEGE BLVD
FULLERTON CA
92831-3547
US

IV. Provider business mailing address

800 N STATE COLLEGE BLVD
FULLERTON CA
92831-3547
US

V. Phone/Fax

Practice location:
  • Phone: 714-278-2800
  • Fax:
Mailing address:
  • Phone: 714-278-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number429692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: