Provider Demographics
NPI:1346362993
Name:MENARD, MICHAEL (R NCS T)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:MENARD
Suffix:
Gender:M
Credentials:R NCS T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10023
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92685-0023
Mailing Address - Country:US
Mailing Address - Phone:714-892-4922
Mailing Address - Fax:714-892-4942
Practice Address - Street 1:14482 BEACH BLVD STE T
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-5341
Practice Address - Country:US
Practice Address - Phone:714-892-4922
Practice Address - Fax:714-892-4942
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic