Healthcare Provider Details

I. General information

NPI: 1023351822
Provider Name (Legal Business Name): SEAN S. SZEJA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SAN BERNARDINO ROAD SUITE 1100
UPLAND CA
91786
US

IV. Provider business mailing address

PO BOX 512185
LOS ANGELES CA
90051-0185
US

V. Phone/Fax

Practice location:
  • Phone: 909-949-2242
  • Fax: 909-981-5783
Mailing address:
  • Phone: 626-256-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberBP10049243
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA152661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: