Provider Demographics
NPI:1134257603
Name:SAUL-LANGFORD, MICHELE LEE (PA-C)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LEE
Last Name:SAUL-LANGFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-3352
Mailing Address - Country:US
Mailing Address - Phone:626-350-9540
Mailing Address - Fax:626-350-9580
Practice Address - Street 1:3030 TYLER AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3352
Practice Address - Country:US
Practice Address - Phone:626-350-9540
Practice Address - Fax:626-350-9580
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14205363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical