Provider Demographics
NPI:1871675827
Name:PAPALIAN, MICHAEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:PAPALIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 EL CAMINO REAL STE B
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1000
Mailing Address - Country:US
Mailing Address - Phone:650-364-6060
Mailing Address - Fax:650-364-9405
Practice Address - Street 1:1515 EL CAMINO REAL STE B
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1000
Practice Address - Country:US
Practice Address - Phone:650-364-6060
Practice Address - Fax:650-364-9405
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG-053446174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52524Medicare UPIN