Provider Demographics
NPI:1164080701
Name:SEAMANDURAS-NAVARRO, ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:
Last Name:SEAMANDURAS-NAVARRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49201 GRAPEFRUIT BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:COACHELLA
Mailing Address - State:CA
Mailing Address - Zip Code:92236-1479
Mailing Address - Country:US
Mailing Address - Phone:760-972-4704
Mailing Address - Fax:760-537-2940
Practice Address - Street 1:49201 GRAPEFRUIT BLVD STE 3
Practice Address - Street 2:
Practice Address - City:COACHELLA
Practice Address - State:CA
Practice Address - Zip Code:92236-1479
Practice Address - Country:US
Practice Address - Phone:760-972-4704
Practice Address - Fax:760-537-2940
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA177187207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine