Healthcare Provider Details

I. General information

NPI: 1104884790
Provider Name (Legal Business Name): MICHAEL H MICHALSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2743 HIGHLAND AVE
NATIONAL CITY CA
91950-7410
US

IV. Provider business mailing address

637 3RD AVE STE E1
CHULA VISTA CA
91910-5707
US

V. Phone/Fax

Practice location:
  • Phone: 844-200-2426
  • Fax: 619-474-4008
Mailing address:
  • Phone: 844-200-2426
  • Fax: 619-356-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG86189
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberG86189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: