Provider Demographics
NPI:1245386192
Name:GIRARD, MICHELE LEON (LM, CPM)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:LEON
Last Name:GIRARD
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:MS
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:GIRARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM, CPM
Mailing Address - Street 1:496 RAINBOW AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-3952
Mailing Address - Country:US
Mailing Address - Phone:323-221-7822
Mailing Address - Fax:323-221-8889
Practice Address - Street 1:496 RAINBOW AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90065-3952
Practice Address - Country:US
Practice Address - Phone:323-221-7822
Practice Address - Fax:323-221-8889
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM 022176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife