Healthcare Provider Details

I. General information

NPI: 1801192521
Provider Name (Legal Business Name): ARTHUR I SEGAL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 01/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 CASA ST
SAN LUIS OBISPO CA
93405-1804
US

IV. Provider business mailing address

PO BOX 1067
SAN LUIS OBISPO CA
93406-1067
US

V. Phone/Fax

Practice location:
  • Phone: 805-544-4883
  • Fax:
Mailing address:
  • Phone: 805-544-4883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG27451
License Number StateCA

VIII. Authorized Official

Name: ARTHUR I SEGAL
Title or Position: PRESIDENT
Credential: MD
Phone: 805-305-1510