Provider Demographics
NPI:1407268493
Name:GREG MICHAELS LLC
Entity Type:Organization
Organization Name:GREG MICHAELS LLC
Other - Org Name:MERIDIAN DAY SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-788-2888
Mailing Address - Street 1:6121 TELEGRAPH RD
Mailing Address - Street 2:STE 200
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-2501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6121 TELEGRAPH RD
Practice Address - Street 2:STE 200
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-2501
Practice Address - Country:US
Practice Address - Phone:323-832-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Multi-Specialty