Organization
BIG BEAR LAKE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL NORMAN DO (PHYSICIAN)
(909) 866-6567
Entity
Organization
Contact information
Practice address
41930 GARSTIN DR, BIG BEAR LAKE, CA 92315
(909) 866-6567
(909) 866-7030
Mailing address
41930 GARSTIN DR PO BOX 2915, BIG BEAR LAKE, CA 92315
(909) 866-6567
(909) 866-7030
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
20A6319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX63190
—
CA
Enumeration date
06/16/2008
Last updated
09/09/2008
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