MEDICARE: DR. GARY SETO M.D.

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	207Q00000X	Family Medicine Physician	G63854	CA

General Provider Information

NPI Number	:	1871599241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY SETO M.D.

Provider Business Mailing Address
First Line	:	1800 FAIR OAKS AVE
Second Line	:	STE A
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4775
Country	:	US
Telephone Number	:	626-441-3298
Fax Number	:	626-441-3087

Provider Business Practice Location Address
First Line	:	1800 FAIR OAKS AVE
Second Line	:	STE A
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-4775
Country	:	US
Telephone Number	:	626-441-3298
Fax Number	:	626-441-3087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/08/2007

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