Organization
DRMICHAELS WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIOS MICHAEL I CNS (DOCTOR)
(626) 440-7406
Entity
Organization
Contact information
Practice address
424 N LAKE AVE STE 102, PASADENA, CA 91101-1202
(626) 440-7406
Mailing address
424 N LAKE AVE STE 102, PASADENA, CA 91101-1202
(626) 440-7406
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
CNS16073
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNS16073
AMA
CA
Enumeration date
06/14/2012
Last updated
06/14/2012
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