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General NPI Number Information
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NPI Number | 1285802256
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Entity Type | Individual
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Provider Name | SEAN NORDT M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 1200 N STATE ST ROOM 1011
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City | LOS ANGELES
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State | CA
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Zip | 90033-1029
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Country | US
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Telephone | 323-226-6667
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14546
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City | IRVINE
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State | CA
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Zip | 92623-4546
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Country | US
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Telephone | 619-818-4593
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A97301
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License Number State | CA
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