Individual
MICHAEL LOUIS ANSELMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1223 WILSHIRE BLVD # 704, SANTA MONICA, CA 90403-5406
(818) 353-1070
(818) 353-1057
Mailing address
1223 WILSHIRE BLVD # 704, SANTA MONICA, CA 90403-5406
(818) 353-1070
(818) 353-1057
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
G40242
CA
Other
Enumeration date
03/23/2016
Last updated
04/18/2024
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