Individual
MYKE FEDERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095-3075
(310) 825-6752
(310) 794-6623
Mailing address
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095-3075
(310) 825-6752
(310) 794-6623
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
A82326
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A823260
—
CA
Enumeration date
02/20/2007
Last updated
08/01/2012
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