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General NPI Number Information
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NPI Number | 1992963714
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Entity Type | Individual
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Provider Name | MICHAEL M SELA MD JD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 2509 PICO BLVD VENICE FAMILY CLINIC
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City | SANTA MONICA
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State | CA
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Zip | 90405-1828
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Country | US
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Telephone | 310-664-7648
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Fax | 310-474-0293
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Provider Business Mailing Address
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Address Line | 10790 WILSHIRE BLVD #401
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City | LOS ANGELES
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State | CA
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Zip | 90024-4426
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Country | US
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Telephone | 310-710-9182
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Fax | 310-474-0293
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A38986
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License Number State | CA
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