Healthcare Provider Details

I. General information

NPI: 1639308984
Provider Name (Legal Business Name): MICHAEL ALYESH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2009
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

PO BOX 5368
BEVERLY HILLS CA
90209-5368
US

V. Phone/Fax

Practice location:
  • Phone: 310-786-7204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA119500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: