Healthcare Provider Details

I. General information

NPI: 1174235451
Provider Name (Legal Business Name): MICHAEL SINFUEGO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 INDIAN HILLS RD STE 371
MISSION HILLS CA
91345-1252
US

IV. Provider business mailing address

11550 INDIAN HILLS RD STE 371
MISSION HILLS CA
91345-1252
US

V. Phone/Fax

Practice location:
  • Phone: 818-927-6686
  • Fax:
Mailing address:
  • Phone: 818-365-1194
  • Fax: 818-898-3835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95025551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: