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General NPI Number Information
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NPI Number | 1922163310
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Entity Type | Individual
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Provider Name | SEAN S TO M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/08/2020
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Provider Practice Location Address
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Address Line | 5562 PHILADELPHIA ST STE 201
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City | CHINO
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State | CA
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Zip | 91710-2482
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Country | US
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Telephone | 909-988-1000
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Fax | 909-988-1001
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Provider Business Mailing Address
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Address Line | 1317 S DIAMOND BAR BLVD UNIT 4462
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City | DIAMOND BAR
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State | CA
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Zip | 91765-5620
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Country | US
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Telephone | 909-988-0000
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Fax | 909-988-1001
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A75204
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License Number State | CA
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