Individual
MR. MICHAEL THOMAS HICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
14400 BEAR VALLEY RD, VICTORVILLE, CA 92392-5470
(760) 951-2000
Mailing address
53 SUNDANCE DR, POMONA, CA 91766-4874
(760) 951-2000
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2317
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GRE001960
—
CA
01
—
P00385025
RR MEDICARE
CA
Enumeration date
10/24/2006
Last updated
02/19/2013
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