Healthcare Provider Details

I. General information

NPI: 1912028648
Provider Name (Legal Business Name): MICHAEL F GIRON MFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GRAVES AVENUE
ROSEMEAD CA
91770-1003
US

IV. Provider business mailing address

7600 GRAVES AVENUE
ROSEMEAD CA
91770-1003
US

V. Phone/Fax

Practice location:
  • Phone: 626-280-6510
  • Fax: 626-288-8903
Mailing address:
  • Phone: 626-280-6510
  • Fax: 626-288-8903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC13926
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: