Healthcare Provider Details

I. General information

NPI: 1841213899
Provider Name (Legal Business Name): MICHAEL A KATZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E VALENCIA MESA DR
FULLERTON CA
92835-3809
US

IV. Provider business mailing address

101 E VALENCIA MESA DR
FULLERTON CA
92835-3809
US

V. Phone/Fax

Practice location:
  • Phone: 714-992-3969
  • Fax: 714-992-3169
Mailing address:
  • Phone: 714-992-3969
  • Fax: 714-992-3169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA77114
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberA77114
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084A2900X
TaxonomyNeurocritical Care Physician
License NumberA77114
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA77114
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA77114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: