Michael Appy

Individual provider Active NPI Physician Assistant · San Pedro, CA

NPI 1104287523 · NPPES record last updated Mar 12, 2016

Key facts

NPI
1104287523
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
04216792 (CA)
Practice address
1643 Westmont Dr
San Pedro, CA 90732-1394
Phone
(310) 430-8308
NPI assigned
Mar 12, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
04216792CAMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 04216792 CA Yes

Addresses

Primary practice location

1643 Westmont Dr
San Pedro, CA 90732-1394

Mailing address

1643 Westmont Dr
San Pedro, CA 90732-1394
Phone (310) 430-8308

Other providers in San Pedro, CA

All providers in San Pedro, CA · Physician Assistant in California

Sources for this page

Verify at the official NPI Registry.