MEDICARE: MICHELLE BROCK RN

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
1	163W00000X	Registered Nurse	95100284	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	95100284	OTHER	CA	CALIFORNIA BOARD OF REGISTERED NURSING

General Provider Information

NPI Number	:	1235742446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE BROCK RN

Provider Business Mailing Address
First Line	:	23655 AQUACATE RD
Second Line	:
City	:	CORONA
State	:	CA
Zip	:	92883-4131
Country	:	US
Telephone Number	:	304-550-4962
Fax Number	:

Provider Business Practice Location Address
First Line	:	4508 ATLANTIC AVE STE A-443
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-1520
Country	:	US
Telephone Number	:	304-550-4962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

Similar Medicare Providers

1750312559 — DESIREE REW LCSW
Practice Location Address:

4508 ATLANTIC AVE # 458
LONG BEACH, CA
90807-1520

Practice Phone: 562-560-4889
Practice Fax:

1346653151 — MARY MCCULLOUGH L.AC.
Practice Location Address:

4508 ATLANTIC AVE STE A505
LONG BEACH, CA
90807-1520

Practice Phone: 310-435-1248
Practice Fax:

1811423882 — CARE MEDICAL SERVICES
Practice Location Address:

4508 ATLANTIC AVE STE 459
LONG BEACH, CA
90807-1520

Practice Phone: 562-507-5464
Practice Fax: 800-401-0056

1336678457 — YASIN K AQUIL
Practice Location Address:

4508 ATLANTIC AVE STE A226
LONG BEACH, CA
90807-1520

Practice Phone: 562-739-4839
Practice Fax:

1750028908 — 180 URBAN COUNSELING LICENSED CLINICAL SOCIAL WORK CORP.
Practice Location Address:

4508 ATLANTIC AVE STE A517
LONG BEACH, CA
90807-1520

Practice Phone: 202-681-2660
Practice Fax: 562-512-6337

1831815786 — KINGDOM CAUSES
Practice Location Address:

4508 ATLANTIC AVE STE 292
LONG BEACH, CA
90807-1520

Practice Phone: 805-722-4900
Practice Fax:

Directions to “ MICHELLE BROCK RN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.