Healthcare Provider Details

I. General information

NPI: 1851402341
Provider Name (Legal Business Name): JOAN SEKLER P.A.-C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

833 LINCOLN BLVD APT 4
SANTA MONICA CA
90403-1516
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-3711
  • Fax: 310-268-4433
Mailing address:
  • Phone: 310-458-6566
  • Fax: 310-458-6566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA10906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: