1417385923 NPI number — DR AYLIN SELEK MD APC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417385923 NPI number — DR AYLIN SELEK MD APC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR AYLIN SELEK MD APC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417385923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8306 WILSHIRE BLVD
Provider Second Line Business Mailing Address:
#820
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90211-2304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-688-7477
Provider Business Mailing Address Fax Number:
310-861-1517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6222 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
#303
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90048-5123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-688-7477
Provider Business Practice Location Address Fax Number:
310-861-1517
Provider Enumeration Date:
10/18/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SELEK
Authorized Official First Name:
AYLIN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
310-688-7477

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)