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General NPI Number Information
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NPI Number | 1508410820
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Entity Type | Individual
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Provider Name | MICHAEL HA DMD,MSD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 333 EL DORADO ST
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City | MONTEREY
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State | CA
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Zip | 93940-4645
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Country | US
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Telephone | 831-373-3068
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Fax |
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Provider Business Mailing Address
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Address Line | 2581 SAMARITAN DR STE 310
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City | SAN JOSE
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State | CA
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Zip | 95124-4112
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Country | US
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Telephone | 408-356-9366
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 107609
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License Number State | CA
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