Provider Demographics
NPI:1053381228
Name:FALCON, MICHELLE L (MD)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:L
Last Name:FALCON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2228 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-5301
Mailing Address - Country:US
Mailing Address - Phone:310-257-2598
Mailing Address - Fax:310-326-3386
Practice Address - Street 1:2228 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-5301
Practice Address - Country:US
Practice Address - Phone:310-257-2598
Practice Address - Fax:310-326-3386
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA49446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA49446HMedicare PIN
WAA49446Medicare PIN
E88850Medicare UPIN