David Edward Michalik, DO
Individual provider Active NPI Pediatric Infectious Diseases Physician · Long Beach, CA
NPI 1194842344 · NPPES record last updated Sep 18, 2007
Key facts
- NPI
- 1194842344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Infectious Diseases Physician 2080P0208X
- License
- 20A10117 (CA)
- Practice address
- 2801 Atlantic Ave
Long Beach, CA 90806-1701 - Phone
- (562) 933-8590
- Fax
- (562) 933-8093
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Infectious Disease
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pediatric Infectology Group Inc
Practice addresses (Care Compare)
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (714) 377-6993
Hospital & facility affiliations
- Memorial Care Miller Children'S & Women'S Hosp LB
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120808000092 | CA | Practitioner - Infectious Disease |
4587810528 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A10117 | CA | MD | Pediatric Infectious Diseases Physician |
| 10117 | CA | MD | Speech-Language Pathologist |
Practice roles (7 of 8)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current |
Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Long Beach Memorial Medical | Past | Accepting new patients | |
| UC Regents Uci Dept of Pediatrics | Past | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Past | Accepting new patients | |
| University of California Irvine | Past | Accepting new patients |
Locations
11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- dmichalik18018@direct.memorialcare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Infectious Diseases Physician | 2080P0208X | 20A10117 | CA | Yes |
Addresses
Primary practice location
2801 Atlantic Ave
Long Beach, CA 90806-1701
Mailing address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone (562) 933-8590
NPI Registry JSON
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190073600000",
"number": "1194842344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061701",
"telephone_number": "562-933-8590",
"fax_number": "562-933-8093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 ATLANTIC AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908061701",
"telephone_number": "562-933-8590",
"fax_number": "562-933-8093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHALIK",
"first_name": "DAVID",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-23",
"last_updated": "2007-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "CA",
"license": "20A10117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Long Beach, CA
- Patricia Michael
- Jonathan Gregory Harris Michaels
- Mark H Michaels
- Peace Michaels
- Perla Michal
- Hancy Michel
- Isabella Michel
- Patrick Michel
- Raymond Michihara
- Michleen Mourice Michael Mickel
All providers in Long Beach, CA · Pediatric Infectious Diseases Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.