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General NPI Number Information
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NPI Number | 1316224025
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Entity Type | Organization
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Legal Business Name | CLIFFORD SEGIL DO A MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 2001 SANTA MONICA BLVD SUITE 1170
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City | SANTA MONICA
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State | CA
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Zip | 90404-2102
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Country | US
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Telephone | 310-828-8838
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Fax | 310-828-2099
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Provider Business Mailing Address
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Address Line | 2001 SANTA MONICA BLVD SUITE 1170
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City | SANTA MONICA
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State | CA
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Zip | 90404-2102
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Country | US
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Telephone | 310-828-8838
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Fax | 310-828-2099
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CLIFFORD SEGIL
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Credential | DO
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Telephone | 310-829-3611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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