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General NPI Number Information
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NPI Number | 1639192032
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Entity Type | Organization
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Legal Business Name | HUMBOLDT PULMONOLOGY
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/27/2012
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Provider Practice Location Address
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Address Line | 3798 JANES RD STE 4
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City | ARCATA
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State | CA
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Zip | 95521-4745
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Country | US
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Telephone | 707-822-8395
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Fax | 707-822-8637
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Provider Business Mailing Address
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Address Line | 3798 JANES RD STE 4
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City | ARCATA
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State | CA
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Zip | 95521-4745
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Country | US
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Telephone | 707-822-8395
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Fax | 707-822-8637
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Authorized Official
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Title or Position | OWNER
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Name | MELVIN SELINGER
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Credential | MD
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Telephone | 707-822-8395
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | C42042
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License Number State | CA
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