Individual
MICHELLE G NOWROOZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1 HOAG DR, NEWPORT BEACH, CA 92663
(949) 610-7245
(657) 241-7720
Mailing address
1 HOAG DR, NEWPORT BEACH, CA 92663-4162
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A12508
CA
208M00000X
Hospitalist Physician
Primary
20A12508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215209093
—
CA
01
—
CB272462
MEDICARE PTAN
CA
Enumeration date
02/08/2012
Last updated
10/26/2020
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