Carl R Selin, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A20803 Issued in CA

Practice address

17400 Irvine Blvd
Suite F
Tustin, CA 92780-3030

Phone

(714) 838-5610

NPI assigned

Aug 22, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1437265352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-838-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 IRVINE BLVD",
            "address_2": "SUITE F",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803030",
            "telephone_number": "714-838-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELIN",
        "first_name": "CARL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A20803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437265352",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP.NPI",
            "identifier": "1689633125",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP #",
            "identifier": "W1779",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Small, D.O., Inc.
• Katie Miranda Scott, LMFT
• Ramon Scruggs, M.D.
• Jean Louis Selam
• Select Specialty RX
• Menuka Senaratne
• Thokozile Donata Senda
• Seneca Family of Agencies
• Wakana Seo
• Seram Village LLC

• Internal Medicine Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.