Michio Abe, MD
Individual provider Active NPI Internal Medicine Physician · Victorville, CA
NPI 1285669671 · NPPES record last updated Mar 6, 2017
Key facts
- NPI
- 1285669671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- A91884 (CA)
- Practice address
- 12408 Hesperia Rd
Suite 21
Victorville, CA 92395-7718 - Phone
- (760) 553-7000
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- George Washington University School of Medicine, 1995
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Noalab Clinic Inc
Practice addresses (Care Compare)
16205 Devonshire St
Suite B
Granada Hills, CA 91344-6949
Phone (818) 488-1442
6428 Coldwater Canyon Ave
North Hollywood, CA 91606-1113
Phone (818) 308-6440
Hospital & facility affiliations
- Provida Home Health, Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 16 |
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 |
|---|---|---|---|---|
| I20060203000602 | CA | Practitioner - Internal Medicine | 0749294221 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (11 of 12)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| And Inc | Current |
Accepting new patients | |
| Noalab Clinic Inc. | Internal Medicine | Current |
Accepting new patients |
| And Inc | Current |
Accepting new patients | |
| Eva Medical Clinic | Current |
Accepting new patients | |
| First Care Medical Group Inc. | Current |
Accepting new patients | |
| Nippon Medical Clinic | Past |
Accepting new patients | |
| Kenneth V. Miselis, M.D. Inc. | Past | Accepting new patients | |
| Joseph M Molina MD Professional Corporation-Southern California | Internal Medicine | Past | Accepting new patients |
| Vvipa Medical Group Inc | Internal Medicine | Past | Accepting new patients |
| High Desert Primary Care | Internal Medicine | Past | Accepting new patients |
| Msji Home Inc | Past |
Accepting new patients |
Locations
16205 Devonshire St
Ste B
Granada Hills, CA 91344
Phone (818) 472-9467
6426 Coldwater Canyon Ave
North Hollywood, CA 91606
Phone (818) 763-2801
6428 Coldwater Canyon Ave
North Hollywood, CA 91606
Phone (818) 308-6440
1655 N Mount Vernon Ave
Ste B1
San Bernardino, CA 92411
Phone (909) 586-6260
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BHIDDD
- https://fhir4.healow.com/fhir/r4/BHIDDD/Endpoint/BHIDDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A91884 | CA | Yes |
Addresses
Primary practice location
12408 Hesperia Rd
Suite 21
Victorville, CA 92395-7718
Mailing address
12370 Hesperia Rd
Suite 6
Victorville, CA 92395-7719
Phone (760) 245-4747
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01363664 | Other | CA | RAILROAD MEDICARE-DU4032; DU4034 |
| APPROVED | Medicaid | CA |
Other providers in Victorville, CA
- A&a Surgery Center
- A&G Health Services, Inc.
- A1 Dental
- Ashley Dee Abarca
- Marco Abdullah
- Syed Adeel Abedi
- Syeda Asra Heydar Abedi
- Abem Transportation Inc
- Christopher Aboagye
- Magdy Aboelghar
All providers in Victorville, CA · Internal Medicine 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 Mar 6, 2017. 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.