Individual
DR. MICHAEL JOSEPH CORNELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
10353 TORRE AVE, SUITE C, CUPERTINO, CA 95014-3217
(408) 446-5811
(408) 996-1637
Mailing address
10353 TORRE AVE, SUITE C, CUPERTINO, CA 95014-3217
(408) 446-5811
(408) 996-1637
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4260
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E4260
STATE LICENSE
CA
Enumeration date
10/02/2006
Last updated
08/10/2021
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