DR. MICHAEL GARY MICHLITSCH (NPI# 1023125259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023125259 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GARY MICHLITSCH |
| Credential | M.D. |
| Practice Address |
2625 Shadelands Dr Walnut Creek CA 94598-2512 |
| Mailing Address |
Po Box 31396 Walnut Creek CA 94598-8396 |
| Practice Telephone | 9259398585 |
| Practice Fax Number | 9259332709 |
| Mailing Telephone | 9259398585 |
| Mailing Fax Number | 9259332709 |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A80093 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2625 SHADELANDS DR |
| City | WALNUT CREEK |
| State | CA |
| Zip Code | 94598-2512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851374243 | Linda Wensley | Occupational Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2005-11-21 |
| 1356956460 | Kali Anne Koziol | Physician Assistant | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2020-09-15 |
| 1972125359 | Jenna K Paynter | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2020-05-08 |
| 1811523020 | Darby June Nordin | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2020-03-19 |
| 1023658440 | Caitlin Mondt | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2020-01-14 |
| 1619517745 | Benjamin Joseph Hubbard | Physician Assistant | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2020-01-07 |
| 1558919944 | James Albertson | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2019-08-28 |
| 1477114809 | Katalin Bela | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2019-06-26 |
| 1770051906 | Hyun Woo Kim | Physical Therapist | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2018-11-06 |
| 1093282576 | Courtney Katz | Orthopaedic Surgery | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2018-11-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639716608 | Tasnim Diaf Moulton | Counselor | 2730 Shadelands Drive, Walnut Creek, CA 94598 | 2019-12-09 |
| 1790255370 | Harmony Grace Davis | Behavior Technician | 2730 Shadelands Drive Bldg 10, Walnut Creek, CA 94598 | 2018-11-27 |
| 1922583772 | Melissa Anne Mcgovern | Behavioral Analyst | 2370 Shadelands Drive, Bldg 10, Walnut Creek, CA 94598 | 2018-09-27 |
| 1184108367 | Brett Heflin Woodrufff | Behavior Technician | 2730 Shandeland Dr. Building 10, Walnut Creek, CA 94598 | 2018-09-24 |
| 1710411640 | Mandy Wei | Pharmacist | 2880 Shadeland Dr, Suite 201, Walnut Creek, CA 94598 | 2017-04-18 |
| 1437683497 | Hayley Miller | Student in an Organized Health Care Education/Training Program | 2204 Lomond Lane, Walnut Creek, CA 94598 | 2017-04-17 |
| 1043601594 | Marlene Perez Riedel | Nurse Practitioner | 450 North Wiget Lane, Walnut Creek, CA 94598 | 2015-02-05 |
| 1922418904 | Dante Michael Sorrentino | Ophthalmology | Kaiser Permanente Park Shadelands Medical Offices, 320 Lennon Lane, Walnut Creek, CA 94598 | 2014-04-30 |
| 1194156505 | Robert Harrison Hubbell | Obstetrics & Gynecology | 838 Stonehaven Dr, Walnut Creek, CA 94598 | 2013-12-11 |
| 1174954192 | Paul Mead | Orthopaedic Surgery | 2405 Shadelands Dr Ste 300, Walnut Creek, CA 94598 | 2013-12-01 |
| Find all providers in zip 94598 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225052681 | Laura A. Timmerman | Orthopaedic Surgery | 230 N. Wiget Lane, Walnut Creek, CA 94598 | 2006-07-27 |
| 1558855437 | Stephen S Chen Md Inc | Orthopaedic Surgery | 1777 Botelho Dr Ste 110, Walnut Creek, CA 94596-5083 | 2018-06-14 |
| 1043616600 | Bay Area Surgical Specialists, Inc | Orthopaedic Surgery | 101 Ygnacio Valley Rd, Suite 400, Walnut Creek, CA 94596-4087 | 2014-11-10 |
| 1558529479 | Charles Francis Preston | Orthopaedic Surgery | 2625 Shadelands Dr, Walnut Creek, CA 94598-2512 | 2008-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790341618 | Casey S Revenko | Orthopaedic Surgery | 2999 Regent St Ste 225, Berkeley, CA 94705-2117 | 2019-05-15 |
| 1225504301 | Amgad Alfred | Orthopaedic Surgery | 18145 Us Highway 18 Ste D, Apple Valley, CA 92307-2210 | 2018-10-16 |
| 1386136430 | Valley River Orthopedics and Sports Medicine | Orthopaedic Surgery | Valley River Orthopedics & Sports Medicine Inc, 3329 G St Ste A, Merced, CA 95340 | 2018-06-05 |
| 1073026696 | Optimal Physician Surgical Group | Orthopaedic Surgery | 25067 Jim Bridger Rd, Hidden Hills, CA 91302-1128 | 2017-11-06 |
| 1336669456 | Beach Cities Orthopedics Surgery Center, LLC | Orthopaedic Surgery | 400 S Sepulveda Blvd Ste 110, Manhattan Beach, CA 90266-6814 | 2017-06-20 |
| 1750818860 | Health Link Medical Group Inc | Orthopaedic Surgery | 899 Northgate Dr Ste 400, San Rafael, CA 94903-3667 | 2017-05-19 |
| 1962861476 | Mehta Orthopedics | Orthopaedic Surgery | 32145 Alvarado Niles Rd Ste 209, Union City, CA 94587-2930 | 2016-02-12 |
| 1649646282 | Bay Area Surgical Specialists, Inc. A Medical Corporation | Orthopaedic Surgery | 5924 Stoneridge Dr Ste 202, Pleasanton, CA 94588-5400 | 2015-08-18 |
| 1114346111 | Sean Robinson | Orthopaedic Surgery | 7551 Timberlake Way Ste 200, Sacramento, CA 95823-5422 | 2014-04-08 |
| 1851717938 | William R Campbell Do Prof Corp | Orthopaedic Surgery | 1 Daniel Burnham Ct Ste 365c, San Francisco, CA 94109-5490 | 2014-03-12 |
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| City | WALNUT CREEK |
| Zip Code | 94598 |
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| 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.