Provider Demographics
NPI:1659309763
Name:CATANZARITE, MICHELLE L (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:CATANZARITE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 GREEN VALLEY CIR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6938
Mailing Address - Country:US
Mailing Address - Phone:424-266-7474
Mailing Address - Fax:
Practice Address - Street 1:5901 GREEN VALLEY CIR
Practice Address - Street 2:SUITE 405
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6938
Practice Address - Country:US
Practice Address - Phone:424-266-7474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.086037207Q00000X
CAC134710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2663185Medicaid
OH4185421Medicare PIN