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NPI Code Detail

MEDICARE: JOHN A SELLING MD

MEDICARE:   JOHN A SELLING  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianG046375CA
2207RG0100XGastroenterology PhysicianG46375CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MMM00087MOTHERNHIC

General Provider Information

NPI Number : 1386608024
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN A SELLING MD
Provider Business Mailing Address
First Line : 340 WILLOWBROOK DR
Second Line :
City : PORTOLA VALLEY
State : CA
Zip : 94028-7842
Country : US
Telephone Number : 650-743-0932
Fax Number :
Provider Business Practice Location Address
First Line : 340 WILLOWBROOK DR
Second Line :
City : PORTOLA VALLEY
State : CA
Zip : 94028-7842
Country : US
Telephone Number : 650-743-0932
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 01/21/2020

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Directions to “ JOHN A SELLING MD” Practice Location

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