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General NPI Number Information
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NPI Number | 1205374527
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Entity Type | Individual
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Provider Name | FRANCIS A DEMICHELE III M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 04/05/2023
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Provider Practice Location Address
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Address Line | 12750 CENTER COURT DR S STE 650
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City | CERRITOS
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State | CA
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Zip | 90703-8569
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Country | US
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Telephone | 323-628-8671
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Fax | 855-883-6300
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Provider Business Mailing Address
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Address Line | 75 FRANCIS ST
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City | BOSTON
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State | MA
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Zip | 02115-6110
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 273676
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License Number State | MA
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