Healthcare Provider Details

I. General information

NPI: 1578596912
Provider Name (Legal Business Name): JOHN S SEDER, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 N BRENT ST
VENTURA CA
93003-2809
US

IV. Provider business mailing address

PO BOX 26570
FRESNO CA
93729-6570
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-5026
  • Fax:
Mailing address:
  • Phone: 559-455-4000
  • Fax: 559-455-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN S SEDER
Title or Position: OWNER
Credential: MD
Phone: 805-652-5026