Healthcare Provider Details

I. General information

NPI: 1972595221
Provider Name (Legal Business Name): SEAN D EARLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W SANTA CLARA ST
VENTURA CA
93001-2543
US

IV. Provider business mailing address

PO BOX 9409
BELFAST ME
04915-9409
US

V. Phone/Fax

Practice location:
  • Phone: 805-641-5600
  • Fax:
Mailing address:
  • Phone: 805-687-2424
  • Fax: 805-687-0885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA60507
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: