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NPI Code Detail

MEDICARE: DR. KEITH P MICHAELS AUD

MEDICARE: DR. KEITH P MICHAELS AUD
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
1237600000XAudiologist-Hearing Aid FitterAU2428CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AU2428OTHERCAAUDIOLOGY LICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4HA7011OTHERCAHEARING AID DISPENSER NUM
5ZZZ62880ZOTHERCABLUE SHIELD

General Provider Information

NPI Number : 1720122450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH P MICHAELS AUD
Provider Business Mailing Address
First Line : 6229 W 87TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3901
Country : US
Telephone Number : 310-677-1168
Fax Number : 310-677-0203
Provider Business Practice Location Address
First Line : 6229 W 87TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3901
Country : US
Telephone Number : 310-677-1168
Fax Number : 310-677-0203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 12/15/2016

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Directions to “ DR. KEITH P MICHAELS AUD” Practice Location

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