Provider Demographics
NPI:1093752636
Name:SENG, HORT (DO)
Entity Type:Individual
Prefix:DR
First Name:HORT
Middle Name:
Last Name:SENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7743 N. WEST LANE
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3350
Mailing Address - Country:US
Mailing Address - Phone:209-477-4380
Mailing Address - Fax:209-477-4584
Practice Address - Street 1:7743 N. WEST LANE
Practice Address - Street 2:SUITE A-1
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3350
Practice Address - Country:US
Practice Address - Phone:209-477-4380
Practice Address - Fax:209-477-4584
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7398207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX73980Medicaid
CA020A73980Medicare ID - Type Unspecified
CAH33145Medicare UPIN