Individual
MICHELLE RAPHAELA ZEIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MEDICAL PLZ, #365 B, LOS ANGELES, CA 90095-3075
(310) 825-8061
(310) 794-9718
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A61508
CA
207RP1001X
Pulmonary Disease Physician
Primary
A61508
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A615080
—
CA
Enumeration date
07/20/2006
Last updated
01/02/2020
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