Provider Demographics
NPI:1477855724
Name:LANGNER, MIKAEL (MD)
Entity Type:Individual
Prefix:
First Name:MIKAEL
Middle Name:
Last Name:LANGNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 TELEGRAPH AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2053
Mailing Address - Country:US
Mailing Address - Phone:858-337-4941
Mailing Address - Fax:415-680-1717
Practice Address - Street 1:3031 TELEGRAPH AVE STE 235
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2053
Practice Address - Country:US
Practice Address - Phone:858-337-4941
Practice Address - Fax:415-680-1717
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC159095208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice