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NPI Code Detail

MEDICARE: CAITLIN ANN MISPAGEL

MEDICARE: CAITLIN ANN MISPAGEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1174315030
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN ANN MISPAGEL
Provider Business Mailing Address
First Line : 1955 18TH ST APT 1
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-4700
Country : US
Telephone Number : 626-394-2720
Fax Number :
Provider Business Practice Location Address
First Line : 1955 18TH ST APT 1
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-4700
Country : US
Telephone Number : 626-394-2720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2025
Last Update Date : 05/19/2025

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Directions to “ CAITLIN ANN MISPAGEL ” Practice Location

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