Provider Demographics
NPI:1639192032
Name:HUMBOLDT PULMONOLOGY
Entity Type:Organization
Organization Name:HUMBOLDT PULMONOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SELINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-822-8395
Mailing Address - Street 1:3798 JANES RD STE 4
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-4745
Mailing Address - Country:US
Mailing Address - Phone:707-822-8395
Mailing Address - Fax:707-822-8637
Practice Address - Street 1:3798 JANES RD STE 4
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-4745
Practice Address - Country:US
Practice Address - Phone:707-822-8395
Practice Address - Fax:707-822-8637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42042207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03514ZMedicare ID - Type Unspecified