Basic Information
| Provider Information | |||||||||
| NPI: | 1497095814 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLOUES | ||||||||
| FirstName: | SETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 COURAGE DR | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945336717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077503000 | ||||||||
| FaxNumber: | 7074287180 | ||||||||
| Practice Location | |||||||||
| Address1: | 2101 COURAGE DR | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945336717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077503000 | ||||||||
| FaxNumber: | 7074287180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2013 | ||||||||
| LastUpdateDate: | 02/21/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 829654 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.