Provider Demographics
NPI:1275649782
Name:SEIP, JEFFREY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:DAVID
Last Name:SEIP
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 1:57402 29 PALMS HWY STE 5
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2957
Mailing Address - Country:US
Mailing Address - Phone:760-365-2520
Mailing Address - Fax:760-365-2524
Practice Address - Street 1:57402 29 PALMS HWY STE 5
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2957
Practice Address - Country:US
Practice Address - Phone:760-365-2520
Practice Address - Fax:760-365-2524
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86692207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A866920Medicaid
CAZZZ31539ZMedicare ID - Type Unspecified
CA6239400001Medicare NSC
CA00A866920Medicaid