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General NPI Number Information
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NPI Number | 1437837879
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Entity Type | Individual
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Provider Name | DOUGLAS MARTIN SIEGMUND FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2010 E 1ST ST STE 100
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City | SANTA ANA
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State | CA
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Zip | 92705-4086
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Country | US
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Telephone | 714-556-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 2915 N. COTTONWOOD ST. UNIT 18
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City | ORANGE
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State | CA
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Zip | 92865
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Country | US
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Telephone | 714-342-8684
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95128967
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95025832
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License Number State | CA
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