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General NPI Number Information
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NPI Number | 1972555142
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Entity Type | Individual
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Provider Name | MICHAEL C HEEG M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 4201 TORRANCE BLVD STE 220
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City | TORRANCE
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State | CA
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Zip | 90503-4537
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Country | US
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Telephone | 310-944-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 TORRANCE BLVD STE 220
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City | TORRANCE
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State | CA
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Zip | 90503-4537
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Country | US
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Telephone | 702-732-4500
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Fax | 702-818-1393
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD2012-0575
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 21154
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License Number State | NV
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