MEDICARE: MICHELLE NICOLE CONTRERAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1003539545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE NICOLE CONTRERAS

Provider Business Mailing Address
First Line	:	320 W HAMMEL ST
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-7130
Country	:	US
Telephone Number	:	323-629-7478
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 W NEWMARK AVE
Second Line	:
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-2818
Country	:	US
Telephone Number	:	626-307-1311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2022
Last Update Date	:	09/20/2022

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Directions to “ MICHELLE NICOLE CONTRERAS ” Practice Location

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