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General NPI Number Information
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NPI Number | 1366672040
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Entity Type | Individual
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Provider Name | SEAN THOMAS LYNCH PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 5525 GROSSMONT CENTER DR #200
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City | LA MESA
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State | CA
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Zip | 91942-3009
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Country | US
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Telephone | 619-644-6500
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Fax | 619-644-6539
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Provider Business Mailing Address
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Address Line | 10280 HOLDEN TRAILS RD
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City | LAKESIDE
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State | CA
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Zip | 92040-2243
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Country | US
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Telephone | 619-672-3217
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA20059
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License Number State | CA
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