Provider Demographics
NPI:1477696185
Name:FARLEY, MICHALYNN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHALYNN
Middle Name:MARIE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 990585
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-0585
Mailing Address - Country:US
Mailing Address - Phone:530-229-9300
Mailing Address - Fax:530-229-9023
Practice Address - Street 1:2401 HARTNELL AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2321
Practice Address - Country:US
Practice Address - Phone:530-229-9300
Practice Address - Fax:530-229-9023
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I70503Medicare UPIN