Provider Demographics
NPI:1619232493
Name:WELSH, SEAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:WILLIAM
Last Name:WELSH
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 1:7624 PAINTER AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2327
Mailing Address - Country:US
Mailing Address - Phone:562-945-9333
Mailing Address - Fax:
Practice Address - Street 1:7624 PAINTER AVE STE 100
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2327
Practice Address - Country:US
Practice Address - Phone:562-945-9333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117868208D00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice