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General NPI Number Information
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NPI Number | 1265188627
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Entity Type | Individual
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Provider Name | SEAN SEVEM PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 4077 5TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-2105
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Country | US
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Telephone | 858-678-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 FAIRBROOK DR
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City | SAINT LOUIS
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State | MO
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Zip | 63131-4215
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Country | US
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Telephone | 314-971-1632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 65571
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License Number State | CA
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