Provider Demographics
NPI:1659568558
Name:SEIDEN, SAMUEL CARY (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:CARY
Last Name:SEIDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:CARY
Other - Last Name:SEIDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1600 EUREKA RD
Mailing Address - Street 2:DEPT OF ANESTHESIA
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3027
Mailing Address - Country:US
Mailing Address - Phone:916-784-4050
Mailing Address - Fax:773-825-8534
Practice Address - Street 1:1600 EUREKA RD
Practice Address - Street 2:DEPT OF ANESTHESIA
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3027
Practice Address - Country:US
Practice Address - Phone:916-784-4050
Practice Address - Fax:773-825-8534
Is Sole Proprietor?:No
Enumeration Date:2007-09-25
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102347207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFJ322ZOtherPTAN