Basic Information
Provider Information
NPI: 1205921749
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEIGLE
FirstName: RICHARD
MiddleName: DUBOE
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 47825 OASIS ST.
Address2:  
City: INDIO
State: CA
PostalCode: 92201
CountryCode: US
TelephoneNumber: 7608638455
FaxNumber: 7608638587
Practice Location
Address1: 47825 OASIS ST.
Address2:  
City: INDIO
State: CA
PostalCode: 92201
CountryCode: US
TelephoneNumber: 7608638455
FaxNumber: 7608638587
Other Information
ProviderEnumerationDate: 10/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XG45936CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home