MICHAEL JOHN MICHAELIDES JR. (NPI# 1003163270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003163270 |
| Entity Type | Individual |
| Full Name | MICHAEL JOHN MICHAELIDES JR. |
| Practice Address |
830 S Azusa Ave Trlr 36 Azusa CA 91702-5582 |
| Practice Telephone | 6265066443 |
| Mailing Telephone | 6268044327 |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2018-03-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
830 S AZUSA AVE TRLR 36 |
| City | AZUSA |
| State | CA |
| Zip Code | 91702-5582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407345341 | Rosaura Contreras | Nutritionist | 109 West 6th Street, Azusa, CA 91702 | 2018-05-07 |
| 1093224396 | Beatriz Leyva Torres | Nurse Practitioner | 237 S. Vernon Ave, Azusa, CA 91702 | 2017-09-29 |
| 1871949370 | Angela Marie Mckindley | Case Manager/Care Coordinator | 23701 East Fork Rd., Azusa, CA 91702 | 2016-05-13 |
| 1023489846 | Crystal Horton | Case Manager/Care Coordinator | 23701 E Fork Road, Azusa, CA 91702 | 2015-10-20 |
| 1528438272 | Seann Mckay | Case Manager/Care Coordinator | 23701 E Folk Rd, Azusa, CA 91702 | 2015-10-06 |
| 1437528833 | William Clabaugh | Case Manager/Care Coordinator | 830 S. Azusa Ave., 45, Azusa, CA 91702 | 2015-09-16 |
| 1467850693 | Juana Gaeta | Speech-Language Pathologist | 1016 E Ghent St, Azusa, CA 91702 | 2014-12-22 |
| 1649674508 | Colleen Anne Montz | Nurse Practitioner | 901 E. Alosta Ave., Student Health Center, Azusa, CA 91702 | 2014-10-21 |
| 1285061390 | Patrick Ryan Bergeron | Physical Therapist | 900 W Sierra Madre Avenue, #33, Azusa, CA 91702 | 2013-10-03 |
| 1760768972 | Ashley L Wickliffe | Student in an Organized Health Care Education/Training Program | 901 East Alosta Avenue, Azusa, CA 91702 | 2011-11-01 |
| Find all providers in zip 91702 | ||||
| Taxonomy Code | 225400000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Rehabilitation Practitioner |
| A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598123309 | Susan Araujo | Rehabilitation Practitioner | 1820 Mirador Dr, Azusa, CA 91702-6245 | 2016-02-08 |
| 1396871901 | Roderic J Tate | Rehabilitation Practitioner | 950 W Sierra Madre Ave, Azusa, CA 91702-1800 | 2007-02-26 |
| 1174893853 | Richard Joseph Bennett | Rehabilitation Practitioner | 23701 E East Fork Rd, Azusa, CA 91702-1477 | 2012-01-11 |
| 1053690586 | Christina Kabiri | Rehabilitation Practitioner | 918 E Alosta Ave, Azusa, CA 91702-2709 | 2011-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861092447 | Isaiah Daniel Clark | Rehabilitation Practitioner | 33600 Mapleton Ave # D2018, Murrieta, CA 92563-4434 | 2020-10-31 |
| 1760089122 | Leslie Ann Showalter | Rehabilitation Practitioner | 6720 Tampa Ave, Reseda, CA 91335-5014 | 2020-10-07 |
| 1508477019 | Brenda Cabrera | Rehabilitation Practitioner | 127 W Hillcrest Blvd, Inglewood, CA 90301-2623 | 2020-08-10 |
| 1669082202 | Brenda Vargas | Rehabilitation Practitioner | 16650 Sherman Way # 201, Van Nuys, CA 91406-3782 | 2020-08-07 |
| 1629696042 | Ashlie Renee Javier | Rehabilitation Practitioner | 1266 Calle Estrella, San Dimas, CA 91773-4080 | 2020-07-13 |
| 1861013757 | Terrisa Noel-rivera Luna | Rehabilitation Practitioner | 11303 Wilshire Blvd Bld 116, Los Angeles, CA 90025-5069 | 2020-05-01 |
| 1780212852 | Isaiah Sanchez | Rehabilitation Practitioner | 10535 Zelzah Ave, Granada Hills, CA 91344-5902 | 2020-04-01 |
| 1235766015 | Theresa Matheson | Rehabilitation Practitioner | 15533 Ryon Ave, Bellflower, CA 90706-3624 | 2020-03-24 |
| 1669008991 | Delman Lee Williams | Rehabilitation Practitioner | 456 E Orange Grove Blvd Ste 140, Pasadena, CA 91104-5235 | 2020-03-18 |
| 1356976864 | Millea Jewel Betts | Rehabilitation Practitioner | 801 E Chapman Ave # Sut203, Fullerton, CA 92831-3839 | 2020-03-04 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MICHAEL JOHN MICHAELIDES JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.