Provider Demographics
NPI:1184871386
Name:SEAN MURRAY MEDICAL CORP
Entity type:Organization
Organization Name:SEAN MURRAY MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-783-1181
Mailing Address - Street 1:4536 BROADWAY UNIT 906
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CA
Mailing Address - Zip Code:95368-2037
Mailing Address - Country:US
Mailing Address - Phone:209-577-9900
Mailing Address - Fax:209-577-1509
Practice Address - Street 1:1191 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9609
Practice Address - Country:US
Practice Address - Phone:805-610-2945
Practice Address - Fax:805-926-3961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG782132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400020116Medicare PIN
BG065Medicare PIN