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General NPI Number Information
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NPI Number | 1457560153
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Entity Type | Individual
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Provider Name | MICHAEL COLLIER CREAMER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 849 W 34TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90089-0079
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Country | US
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Telephone | 213-740-0466
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Fax |
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Provider Business Mailing Address
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Address Line | 840 HAVERFORD AVE APT 1
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-4379
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Country | US
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Telephone | 310-459-5910
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA11683
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License Number State | CA
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