Healthcare Provider Details

I. General information

NPI: 1134244635
Provider Name (Legal Business Name): MICHELLE EHRLICH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ROSECRANS AVE STE 105
MANHATTAN BEACH CA
90266-2470
US

IV. Provider business mailing address

1200 ROSECRANS AVE STE 105
MANHATTAN BEACH CA
90266-2470
US

V. Phone/Fax

Practice location:
  • Phone: 310-546-7546
  • Fax: 310-546-6777
Mailing address:
  • Phone: 310-546-7546
  • Fax: 310-546-6777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA85530
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA85530
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: