Provider Demographics
NPI:1558325365
Name:SEBAHAR, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:SEBAHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 METROPOLITAN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-3096
Mailing Address - Country:US
Mailing Address - Phone:760-753-7127
Mailing Address - Fax:760-607-0282
Practice Address - Street 1:6221 METROPOLITAN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-3096
Practice Address - Country:US
Practice Address - Phone:760-753-7127
Practice Address - Fax:760-607-0282
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84381207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G843810Medicaid
CAF63132Medicare UPIN
CA00G843810Medicaid