Provider Demographics
NPI:1750475828
Name:MURRAY, MICHAEL TODD (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:MURRAY
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 1:6060 HELLYER AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1046
Mailing Address - Country:US
Mailing Address - Phone:408-227-6300
Mailing Address - Fax:408-227-6314
Practice Address - Street 1:6060 HELLYER AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1046
Practice Address - Country:US
Practice Address - Phone:408-227-6300
Practice Address - Fax:408-227-6314
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA79157207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
008791571OtherMEDICARE PTAN
I07667Medicare UPIN