Healthcare Provider Details

I. General information

NPI: 1811181241
Provider Name (Legal Business Name): ANDORRA SEAGER CST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23456 HAWTHORNE BLVD SUITE 200
TORRANCE CA
90505-4716
US

IV. Provider business mailing address

23456 HAWTHORNE BLVD STE 200
TORRANCE CA
90505-4716
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-8700
  • Fax:
Mailing address:
  • Phone: 310-375-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: