MEDICARE: SHARLEE MOSBURG-MICHAEL

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	235Z00000X	Speech-Language Pathologist	5448	CA

General Provider Information

NPI Number	:	1881883924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARLEE MOSBURG-MICHAEL

Provider Business Mailing Address
First Line	:	4350 MOUNT EVEREST BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-4847
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 MOUNT EVEREST BLVD
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-4847
Country	:	US
Telephone Number	:	858-496-8222
Fax Number	:

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

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	10/15/2007

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Directions to “ SHARLEE MOSBURG-MICHAEL ” Practice Location

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