Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0004X | Dentist Anesthesiologist | 137.000670.019.02690 | CA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 019026904 | IL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 60053 | CA |
NPI | 1396843009 |
---|---|
Provider Name | Dr. Michelle Marie Pashley |
First Address | Santa Ana, CA 92705-2353 |
Second Address | Laguna Hills, CA 92653-4337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 17/11/2020 |