Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 20A10117 | CA |
NPI | 1194842344 |
---|---|
Provider Name | Dr. David Edward Michalik |
First Address | Long Beach, CA 90806-1701 |
Second Address | Long Beach, CA 90806-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 18/09/2007 |