Provider Demographics
NPI:1386692424
Name:SEAGREN, STEPHEN L (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:L
Last Name:SEAGREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5413 AVENIDA FIESTA
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7202
Mailing Address - Country:US
Mailing Address - Phone:858-822-6040
Mailing Address - Fax:
Practice Address - Street 1:3855 HEALTH SCIENCES DR. 0843
Practice Address - Street 2:MOORES UCSD CANCER CENTER
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0843
Practice Address - Country:US
Practice Address - Phone:585-822-6040
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG 241592085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology