Provider Demographics
NPI:1841382215
Name:STEVEN T MICHEL DPM
Entity Type:Organization
Organization Name:STEVEN T MICHEL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LORELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-482-0711
Mailing Address - Street 1:2460 PONDEROSA DRIVE NORTH
Mailing Address - Street 2:A105
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010
Mailing Address - Country:US
Mailing Address - Phone:805-482-0711
Mailing Address - Fax:805-482-6524
Practice Address - Street 1:2460 PONDEROSA DRIVE NORTH
Practice Address - Street 2:A105
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010
Practice Address - Country:US
Practice Address - Phone:805-482-0711
Practice Address - Fax:805-482-6524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1845213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E18450OtherMEDICAL
T11074Medicare UPIN
CA000E18450OtherMEDICAL