Provider Demographics
NPI:1164573093
Name:SETO, NORMAN SHIGEO (OD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:SHIGEO
Last Name:SETO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:79600 BUTLER BAY PL
Mailing Address - Street 2:
Mailing Address - City:BERMUDA DUNES
Mailing Address - State:CA
Mailing Address - Zip Code:92203-1297
Mailing Address - Country:US
Mailing Address - Phone:760-345-2835
Mailing Address - Fax:760-347-9301
Practice Address - Street 1:45655 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-4564
Practice Address - Country:US
Practice Address - Phone:760-347-5191
Practice Address - Fax:760-347-9301
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7766152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist