Healthcare Provider Details

I. General information

NPI: 1629502828
Provider Name (Legal Business Name): CHRISTOPHER MIKHAIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 S SAN VICENTE BLVD STE 900
LOS ANGELES CA
90048-4169
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-9900
  • Fax: 310-423-9958
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number314190
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA186285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: