Provider Demographics
NPI:1871828285
Name:SEABREEZE MEDICAL INC
Entity type:Organization
Organization Name:SEABREEZE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-382-5718
Mailing Address - Street 1:8132 FIRESTONE BLVD
Mailing Address - Street 2:STE 930
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8132 FIRESTONE BLVD
Practice Address - Street 2:STE 930
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4231
Practice Address - Country:US
Practice Address - Phone:562-382-5718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-03
Last Update Date:2009-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC27652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty