Healthcare Provider Details

I. General information

NPI: 1891865689
Provider Name (Legal Business Name): MICHAEL DMITRI BELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 52ND ST EMERGENCY DEPT CHILDRENS HOSPITAL OAKLAND
OAKLAND CA
94609
US

IV. Provider business mailing address

717 52ND ST EMERGENCY DEPT CHILDRENS HOSPITAL OAKLAND
OAKLAND CA
94609
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3259
  • Fax:
Mailing address:
  • Phone: 510-428-3259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number657098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: