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Individual

DR. MARIOS C MICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, CNS, DAAPM

Contact information

Practice address
424 N. LAKE AVE., SUITE 102, PASADENA, CA 91101
(626) 440-7406
(866) 379-0950
Mailing address
424 N. LAKE AVE., SUITE 102, PASADENA, CA 91101
(626) 440-7406
(866) 379-0950

Taxonomy

Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
DC27129
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DC0271290
BLUE SHEILD
CA
Enumeration date
03/13/2007
Last updated
10/15/2015
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