Provider Demographics
NPI:1801197934
Name:DIGIUSEPPE, MICHAEL ANGELO (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANGELO
Last Name:DIGIUSEPPE
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:18321 CLARK ST
Mailing Address - Street 2:PODIATRY DEPARTMENT
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3501
Mailing Address - Country:US
Mailing Address - Phone:818-633-9497
Mailing Address - Fax:928-438-3974
Practice Address - Street 1:18321 CLARK ST
Practice Address - Street 2:PODIATRY DEPARTMENT
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3501
Practice Address - Country:US
Practice Address - Phone:818-633-9497
Practice Address - Fax:928-438-3974
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2021-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAEL1736213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery