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NPI Code Detail

MEDICARE: DR. MICHAEL DECKER D.O.

MEDICARE: DR. MICHAEL DECKER D.O.
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
1208100000XPhysical Medicine & Rehabilitation Physician20A13087CA

General Provider Information

NPI Number : 1124463229
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL DECKER D.O.
Provider Business Mailing Address
First Line : 565 PIER AVE
Second Line : #1352
City : HERMOSA BEACH
State : CA
Zip : 90254-8200
Country : US
Telephone Number : 816-896-1355
Fax Number :
Provider Business Practice Location Address
First Line : 2725 E BROADWAY
Second Line :
City : LONG BEACH
State : CA
Zip : 90803-5431
Country : US
Telephone Number : 562-434-4494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2013
Last Update Date : 06/13/2016

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