Healthcare Provider Details

I. General information

NPI: 1962894220
Provider Name (Legal Business Name): MICHAEL WILLIAM FIORE PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

IV. Provider business mailing address

3330 LOMITA BLVD
TORRANCE CA
90505-5002
US

V. Phone/Fax

Practice location:
  • Phone: 310-784-4997
  • Fax:
Mailing address:
  • Phone: 310-784-4997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number018481
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number54224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: