Healthcare Provider Details

I. General information

NPI: 1912925611
Provider Name (Legal Business Name): MICHA, RETTENMAIER, BROWN & LACEY A CALIFORNIA PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23600 TELO AVE STE 250
TORRANCE CA
90505-4037
US

IV. Provider business mailing address

625 THE CITY DR S STE 310
ORANGE CA
92868-4949
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-8446
  • Fax: 310-375-8489
Mailing address:
  • Phone: 310-375-8446
  • Fax: 310-375-8489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: FIKRET ATAMDEDE
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 310-567-2534