Individual
MARY M MICHEL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 N VERMONT AVE, #610, LOS ANGELES, CA 90027
(323) 665-5600
(323) 665-8502
Mailing address
PO BOX 781, LA CANADA, CA 91012
(323) 665-5600
(323) 665-8500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
E31042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A310420
—
CA
Enumeration date
02/24/2006
Last updated
07/08/2007
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