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Individual

MR. MICHAEL LANCE CALUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, RN, BSN

Contact information

Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-3277
Mailing address
259 SAINT KATHERINE DR, LA CANADA, CA 91011-4110
(818) 804-1080

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN95242786
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
NP95030479
CA

Other

Enumeration date
06/24/2024
Last updated
06/24/2024
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