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General NPI Number Information
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NPI Number | 1053683797
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Entity Type | Organization
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Legal Business Name | S&I CAPITAL LLC
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 939 COAST BLVD UNIT 18E
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City | LA JOLLA
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State | CA
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Zip | 92037-4149
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Country | US
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Telephone | 858-354-4640
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Fax |
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Provider Business Mailing Address
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Address Line | 939 COAST BLVD UNIT 19D
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City | LA JOLLA
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State | CA
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Zip | 92037-4169
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Country | US
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Telephone | 858-354-4640
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. SEAN K TAYEBI
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Credential | FACOG
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Telephone | 858-354-4640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | A51498
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License Number State | CA
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