Provider Demographics
NPI:1619081015
Name:TEEL, MICHAEL W (CPO)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:W
Last Name:TEEL
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:TEEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPO
Mailing Address - Street 1:1453 SALEM CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-1810
Mailing Address - Country:US
Mailing Address - Phone:858-642-3082
Mailing Address - Fax:858-642-1417
Practice Address - Street 1:1453 SALEM CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-1810
Practice Address - Country:US
Practice Address - Phone:858-642-3082
Practice Address - Fax:858-642-1417
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Not Answered224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Not Answered225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter