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General NPI Number Information
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NPI Number | 1134348402
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Entity Type | Organization
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Legal Business Name | BETH SIEGLER, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 633 OCEAN AVE SUITE # 11
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City | SANTA MONICA
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State | CA
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Zip | 90402-2613
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Country | US
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Telephone | 310-451-9098
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Fax | 310-319-3519
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Provider Business Mailing Address
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Address Line | 633 OCEAN AVE SUITE # 11
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City | SANTA MONICA
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State | CA
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Zip | 90402-2613
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Country | US
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Telephone | 310-451-9098
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Fax | 310-319-3519
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Authorized Official
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Title or Position | OWNER
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Name | BETH ANN SIEGLER
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Credential | M.D.
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Telephone | 310-451-9098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A84446
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License Number State | CA
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