Individual
MICHELLE MARIA PIETZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 W SUNSET BLVD, LOS ANGELES, CA 90027-6062
(323) 361-2181
(323) 664-0718
Mailing address
6430 SUNET BLVD, SUITE 600, LOS ANGELES, CA 90028-7900
(323) 361-2337
(323) 644-8488
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
G78750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005787500
—
CA
Enumeration date
10/03/2006
Last updated
07/21/2022
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