Provider Demographics
NPI:1144719568
Name:SIGLIN, IRVIN STEVEN III (LMT)
Entity type:Individual
Prefix:
First Name:IRVIN
Middle Name:STEVEN
Last Name:SIGLIN
Suffix:III
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WINDSOR RISE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-687-8986
Mailing Address - Fax:
Practice Address - Street 1:27820 DORRIS DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:CARMEL-BY-THE-SEA
Practice Address - State:CA
Practice Address - Zip Code:93923
Practice Address - Country:US
Practice Address - Phone:831-687-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist