Provider Demographics
NPI:1053580795
Name:LAURENCE SEIGLER, M.D. PC
Entity type:Organization
Organization Name:LAURENCE SEIGLER, M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:310-274-6158
Mailing Address - Street 1:435 N BEDFORD DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4321
Mailing Address - Country:US
Mailing Address - Phone:310-274-6158
Mailing Address - Fax:310-274-5709
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:SUITE 308
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-274-6158
Practice Address - Fax:310-274-5709
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAURENCE SEIGLER, M. D. A PROFESSIONAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-27
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC27771207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty