Provider Demographics
NPI:1619292372
Name:SEIPP, SHARLENE MARIE MATEO (MD)
Entity type:Individual
Prefix:MRS
First Name:SHARLENE MARIE
Middle Name:MATEO
Last Name:SEIPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHARLENE MARIE
Other - Middle Name:CRUZET
Other - Last Name:MATEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4650 W SUNSET BLVD MS #3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:408-504-3789
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD MS #3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:408-504-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA119311207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program