Active NPI
Paul E Michelson, MD
- Ophthalmology Physician
- La Jolla, CA
National Provider Identifier
1932221132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A35074
- Practice address
- 9834 Genesee Ave
Suite 200
La Jolla, CA 92037-1223 - Phone
- (858) 457-3050
- Fax
- (858) 457-0851
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A35074 | CA | Primary |
Addresses
Primary practice location
9834 Genesee Ave
Suite 200
La Jolla, CA 92037-1223
Mailing address
9834 Genesee Ave
Suite 200
La Jolla, CA 92037-1223
Phone (858) 457-3050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C32830 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A35074 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932221132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9834 GENESEE AVE",
"address_2": "SUITE 200",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371223",
"telephone_number": "858-457-3050",
"fax_number": "858-457-0851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9834 GENESEE AVE",
"address_2": "SUITE 200",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371223",
"telephone_number": "858-457-3050",
"fax_number": "858-457-0851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELSON",
"first_name": "PAUL",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A35074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "C32830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.