MEDICARE: DAVID C SELTZER M.D. A MEDICAL CORPORATION

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
1	207YS0123X	Facial Plastic Surgery Physician	G16796	CA

General Provider Information

NPI Number	:	1407139660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID C SELTZER M.D. A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	650 ALAMO PINTADO RD
Second Line	:	SUITE 101
City	:	SOLVANG
State	:	CA
Zip	:	93463-2266
Country	:	US
Telephone Number	:	805-618-1242
Fax Number	:	805-259-4080

Provider Business Practice Location Address
First Line	:	650 ALAMO PINTADO RD
Second Line	:	SUITE 101
City	:	SOLVANG
State	:	CA
Zip	:	93463-2266
Country	:	US
Telephone Number	:	805-618-1242
Fax Number	:	805-259-4080

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	CHRIS SELTZER
Credential	:	R.N.
Telephone Number	:	805-688-7079

Provider Enumeration Date	:	09/23/2011
Last Update Date	:	10/22/2013

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