Individual
DR. MICHAEL JOSEPH NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 S MAIN ST STE 200, ORANGE, CA 92868-3852
(714) 634-4567
Mailing address
8950A (CAMPUS DELIVERY CODE) 2450 RIVERSIDE AVE, PEDIATRICS EDUCATION OFFICE 1ST FLOOR EAST BUILDING, MINNEAPOLIS, MN 55454
(612) 624-4477
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
A168679
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/09/2016
Last updated
07/13/2020
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