Selecky, Mark T

Selecky, Mark T is an individual health care provider with primary practice located at 955 Lane Ave Suite 200, Chula Vista CA 91914-3501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Selecky, Mark T can be contacted via phone (619) 421-3400.

Contact Information

Primary practice address
955 Lane Ave Suite 200 Chula Vista CA 91914-3501
Phone: (619) 421-3400
Fax: (619) 421-3557
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X G78136 California

Profile Details

NPI number 1669414850
LBN Legal business name Selecky, Mark T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Jun 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1669414850 NPPES
California MEDICAID 00G781360

Popular Providers