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General NPI Number Information
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NPI Number | 1578924015
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Entity Type | Organization
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Legal Business Name | DN MICHELSON MD INC.
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 1889 N RICE AVE SUITE 201
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City | OXNARD
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State | CA
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Zip | 93030-7270
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Country | US
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Telephone | 805-485-3888
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Fax | 805-485-5810
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Provider Business Mailing Address
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Address Line | 1889 N RICE AVE SUITE 201
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City | OXNARD
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State | CA
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Zip | 93030-7270
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Country | US
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Telephone | 805-485-3888
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Fax | 805-485-5810
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Authorized Official
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Title or Position | CEO
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Name | DR. DAVID MICHELSON
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Credential | MD
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Telephone | 805-485-3888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | G31906
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License Number State | CA
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