| Doctor Name: | SETH HOLM |
| NPI Number: | 1285063362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 95000059 |
| Business Practice Address: | 20615 Ponderosa Way Tuolumne, CA - 953799735 |
| Business Phone Number: | 2099283174 |
| Business Fax Number: | |
| Mailing Address: | 6920 Miramar Rd, SAN DIEGO |
| State: | CA |
| Postal Code: | 921212632 |
| Phone Number: | 8585304856 |
| Fax Number: | |
| NPI Enumeration Date: | 11/08/2013 |
| NPI Last Update Date: | 11/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 95000059 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |