1427644384 NPI number — MISS MICHELLE CHRISTINE PARSONS DPT, PT, ATC

Table of content: MISS MICHELLE CHRISTINE PARSONS DPT, PT, ATC (NPI 1427644384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427644384 NPI number — MISS MICHELLE CHRISTINE PARSONS DPT, PT, ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARSONS
Provider First Name:
MICHELLE
Provider Middle Name:
CHRISTINE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
DPT, PT, ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLLINS
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
CHRISTINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT, PT, ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427644384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/21/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3230 E IMPERIAL HWY STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92821-6735
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-256-5074
Provider Business Mailing Address Fax Number:
714-256-0770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13931 CARROLL WAY STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUSTIN
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92780-1861
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-988-8120
Provider Business Practice Location Address Fax Number:
714-988-8119
Provider Enumeration Date:
12/15/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  299254 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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