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NPI Code Detail

MEDICARE: DR. MICHAEL R. VELARDE M.D.

MEDICARE: DR. MICHAEL R. VELARDE M.D.
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
1207Q00000XFamily Medicine PhysicianG45796CA

General Provider Information

NPI Number : 1427031418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL R. VELARDE M.D.
Provider Business Mailing Address
First Line : 504 PLAZA DR
Second Line :
City : SANTA MARIA
State : CA
Zip : 93454-6917
Country : US
Telephone Number : 805-739-3474
Fax Number : 805-346-3548
Provider Business Practice Location Address
First Line : 877 OAK PARK BLVD
Second Line :
City : PISMO BEACH
State : CA
Zip : 93449-3292
Country : US
Telephone Number : 805-474-8450
Fax Number : 805-474-8454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 06/10/2016

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