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General NPI Number Information
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NPI Number | 1639313653
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Entity Type | Individual
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Provider Name | MICHAEL PAVAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 24509 WALNUT ST STE 101
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City | NEWHALL
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State | CA
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Zip | 91321-2846
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Country | US
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Telephone | 661-776-4500
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Fax | 661-253-9601
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Provider Business Mailing Address
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Address Line | 24509 WALNUT ST STE 101
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City | NEWHALL
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State | CA
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Zip | 91321-2846
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Country | US
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Telephone | 661-776-4500
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Fax | 661-253-9601
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC31242
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC31242
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License Number State | CA
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