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General NPI Number Information
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NPI Number | 1659631208
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Entity Type | Individual
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Provider Name | MICHELLE LISE DALEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/16/2012
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 3910 VISTA WAY STE 106
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City | OCEANSIDE
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State | CA
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Zip | 92056-4513
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Country | US
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Telephone | 760-941-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 414 SHADOW TREE DR
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City | OCEANSIDE
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State | CA
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Zip | 92058-7023
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110003843
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C0004733
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA66482
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License Number State | CA
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