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General NPI Number Information
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NPI Number | 1952479339
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Entity Type | Individual
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Provider Name | MICHELLE D HENRY M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 1401 S GRAND AVE
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City | LOS ANGELES
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State | CA
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Zip | 90015-3010
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Country | US
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Telephone | 213-742-5716
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Fax | 213-742-5731
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Provider Business Mailing Address
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Address Line | 21021 TOMLEE AVE
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City | TORRANCE
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State | CA
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Zip | 90503-4064
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Country | US
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Telephone | 310-818-1989
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Fax | 213-742-5731
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | G74047
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License Number State | CA
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