Provider Demographics
NPI:1790787174
Name:SEGAL, ARTHUR I (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:I
Last Name:SEGAL
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 1:184 CASA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-1804
Mailing Address - Country:US
Mailing Address - Phone:805-544-4883
Mailing Address - Fax:805-542-0827
Practice Address - Street 1:184 CASA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-1804
Practice Address - Country:US
Practice Address - Phone:805-544-4883
Practice Address - Fax:805-542-0827
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27451207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC71033FMedicaid
160051728OtherRR MEDICARE PIN
770434767 93401 D002OtherCHAMPUS/TRICARE
CAF70812FMedicaid
4158640001OtherNSC #
770434767 93401 D002OtherCHAMPUS/TRICARE
CA551906Medicare Oscar/Certification
CAW1508FMedicare PIN
CA551982Medicare Oscar/Certification
00G274510Medicare PIN
CAA91053Medicare UPIN