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General NPI Number Information
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NPI Number | 1831484526
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Entity Type | Organization
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Legal Business Name | PACIFIC CENTER FOR OCULOFACIAL AND AESTHETIC PLASTIC SURGERY PC
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 50 S SAN MATEO DRIVE SUITE 320
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City | SAN MATEO
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State | CA
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Zip | 94401-3861
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Country | US
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Telephone | 650-340-9763
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Fax | 650-340-9514
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Provider Business Mailing Address
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Address Line | 50 S SAN MATEO DRIVE SUITE 320
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City | SAN MATEO
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State | CA
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Zip | 94401-3861
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Country | US
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Telephone | 650-340-9763
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Fax | 650-340-9514
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Authorized Official
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Title or Position | CEO
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Name | DR. STUART RONALD SEIFF
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Credential | MD
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Telephone | 650-340-9763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G45235
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License Number State | CA
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