Provider Demographics
NPI:1902034721
Name:MONI, MICHAL HENRY (LPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAL
Middle Name:HENRY
Last Name:MONI
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0257
Practice Address - Street 1:52 DORE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3828
Practice Address - Country:US
Practice Address - Phone:415-553-3100
Practice Address - Fax:415-553-3119
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18365167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician