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General NPI Number Information
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NPI Number | 1114699410
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Entity Type | Organization
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Legal Business Name | MICHELLE ISCHAYEK DO PC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1055 W 7TH ST STE 1770
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City | LOS ANGELES
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State | CA
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Zip | 90017-3019
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Country | US
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Telephone | 310-651-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 287 S ROBERTSON # 319
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2810
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHELLE ISCHAYEK
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Credential | DO
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Telephone | 310-651-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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