Individual
LIDIA MICHEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1304 15TH ST STE 102, SANTA MONICA, CA 90404-1810
(310) 319-4080
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP 21678
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
NP 21678
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN628435
—
CA
Enumeration date
09/14/2012
Last updated
12/30/2019
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