=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760402762
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL STEVEN SINEL M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2006
-----------------------------------------------------
Last Update Date | 02/04/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1441 BROADWAY
-----------------------------------------------------
City | SANTA MONICA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90404-2711
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-393-2225
-----------------------------------------------------
Fax | 310-593-2843
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1223 WILSHIRE BLVD SUITE 1511
-----------------------------------------------------
City | SANTA MONICA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90403-5400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-393-2225
-----------------------------------------------------
Fax | 310-593-2843
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2081P2900X
-----------------------------------------------------
Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
-----------------------------------------------------
License Number | G65692
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------