Daniela Micic MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A122430 Issued in CA

Legal business name

DANIELA MICIC MD INC

Practice address

2021 Santa Monica Blvd Ste 724E
Santa Monica, CA 90404-2170

Phone

(310) 829-9060

NPI assigned

May 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Daniela Micic, MD

Title

Sole Owner/President

Phone

(213) 840-8284

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1679063622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7001",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913577001",
            "telephone_number": "818-888-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 724E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042170",
            "telephone_number": "310-829-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIELA MICIC MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "MICIC",
        "authorized_official_first_name": "DANIELA",
        "authorized_official_title_or_position": "SOLE OWNER/PRESIDENT",
        "authorized_official_telephone_number": "213-840-8284",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A122430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.