Healthcare Provider Details

I. General information

NPI: 1023738978
Provider Name (Legal Business Name): SEAN SEAL-HOROWITZ HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 SPECTRUM CENTER DR STE 821
IRVINE CA
92618-4956
US

IV. Provider business mailing address

750 N COMMONS DR STE 200
AURORA IL
60504-7940
US

V. Phone/Fax

Practice location:
  • Phone: 949-504-9090
  • Fax: 949-504-9090
Mailing address:
  • Phone: 630-303-5380
  • Fax: 630-303-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA8457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: