Provider Demographics
NPI:1497800569
Name:ASHNIN, MICHAEL MENDEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MENDEL
Last Name:ASHNIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:136 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-7002
Mailing Address - Country:US
Mailing Address - Phone:805-736-3164
Mailing Address - Fax:805-736-3164
Practice Address - Street 1:508 E HICKORY AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-7337
Practice Address - Country:US
Practice Address - Phone:805-737-3300
Practice Address - Fax:805-737-3300
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA55508207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0058550Medicaid
CAGR0058550Medicaid
CAG75982Medicare UPIN