Healthcare Provider Details

I. General information

NPI: 1447909809
Provider Name (Legal Business Name): DANIEL ANGELO MICHELI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6699 ALVARADO RD STE 2308
SAN DIEGO CA
92120-5241
US

IV. Provider business mailing address

6010 HIDDEN VALLEY RD STE 200
CARLSBAD CA
92011-4219
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-3000
  • Fax: 760-631-3016
Mailing address:
  • Phone: 760-631-3000
  • Fax: 760-631-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA187430
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: