Individual
JESSICA COLE MCMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1310 W STEWART DR, SUITE 508, ORANGE, CA 92868-3854
(714) 633-2111
(714) 633-5615
Mailing address
1310 W STEWART DR, SUITE 508, ORANGE, CA 92868-3854
(714) 633-2111
(714) 633-5615
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A125386
CA
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
A125386
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB244893
MEDICARE PTAN
CA
Enumeration date
06/14/2007
Last updated
05/03/2016
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