# MICHAEL DAVID HOLLETT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811931611
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085B0100X | Body Imaging Physician | G75906 | CA | Yes |
| 2085R0202X | Diagnostic Radiology Physician | G75906 | CA | — |

## Other

- **Enumeration date:** 06/15/2006
- **Last updated:** 04/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00G759060 | BLUE CROSS OF CA | CA |
| 05 | — | 00G759060 | — | CA |
| 01 | — | 300121752 | RAILROAD MEDICARE | CA |
| 01 | — | 300121782 | RAILROAD MEDICARE | CA |