Healthcare Provider Details

I. General information

NPI: 1619381779
Provider Name (Legal Business Name): MICHELLE YIXIAO ENGLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. MICHELLE YIXIAO WANG

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 N SAN ANTONIO RD STE 101
LOS ALTOS CA
94022
US

IV. Provider business mailing address

960 N SAN ANTONIO RD STE 101
LOS ALTOS CA
94022-1346
US

V. Phone/Fax

Practice location:
  • Phone: 650-498-9000
  • Fax:
Mailing address:
  • Phone: 650-498-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA139134
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA139134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: