MEDICARE: MICHAEL A. DOUGLAS, PHD

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1780824219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A. DOUGLAS, PHD

Provider Business Mailing Address
First Line	:	11704 WILSHIRE BLVD STE 255
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1504
Country	:	US
Telephone Number	:	310-405-1948
Fax Number	:	323-934-1550

Provider Business Practice Location Address
First Line	:	11704 WILSHIRE BLVD STE 255
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-1504
Country	:	US
Telephone Number	:	310-405-1948
Fax Number	:	323-934-1550

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. MICHAEL DOUGLAS
Credential	:
Telephone Number	:	310-405-1948

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

Similar Medicare Providers

1417089061 — MR. JAMES CLARK ROACH L.M.F.T
Practice Location Address:

11704 WILSHIRE BLVD STE 250
LOS ANGELES, CA
90025-1504

Practice Phone: 310-488-1274
Practice Fax:

1619001203 — DR. SHIRIN KASHANI D.A.O.M., L.AC.
Practice Location Address:

11704 WILSHIRE BLVD STE 206
LOS ANGELES, CA
90025-1504

Practice Phone: 310-740-2889
Practice Fax:

1043452840 — DR. ALEXA K ALTMAN PH.D.
Practice Location Address:

11704 WILSHIRE BLVD STE 255
LOS ANGELES, CA
90025-1504

Practice Phone: 323-414-4141
Practice Fax:

1467051672 — SPEARHEAD HEALTH CENTERS, LLC.
Practice Location Address:

11704 WILSHIRE BLVD STE 226
LOS ANGELES, CA
90025-1504

Practice Phone: 310-494-7356
Practice Fax:

1316049463 — GARY L ZAGELBAUM, MD A PROF CORP
Practice Location Address:

6200 WILSHIRE BLVD , SUITE 1504
LOS ANGELES, CA
90048-5816

Practice Phone: 323-857-1323
Practice Fax: 323-857-7089

1710078472 — DR. DIANA AKOPYAN D.D.S.
Practice Location Address:

1127 WILSHIRE BLVD , SUITE 1504
LOS ANGELES, CA
90017-3901

Practice Phone: 213-201-1388
Practice Fax:

Directions to “MICHAEL A. DOUGLAS, PHD ” 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.