Provider Demographics
NPI:1134390990
Name:MICHELLE M. ALGARIN, M.D., INC
Entity type:Organization
Organization Name:MICHELLE M. ALGARIN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ALGARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-855-3376
Mailing Address - Street 1:23961 CALLE DE LA MAGDALENA
Mailing Address - Street 2:# 520
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3616
Mailing Address - Country:US
Mailing Address - Phone:949-855-3376
Mailing Address - Fax:949-609-1971
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:# 520
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-855-3376
Practice Address - Fax:949-609-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85189207ND0101X, 207ND0900X, 207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00092882OtherRAILROAD MEDICARE PROVIDER #
CAG48305OtherUPIN #
CAG85189OtherSTATE LICENSE #
CAWG85189IOtherMEDICARE INDIVIDUAL PTAN
CABA6318869OtherDEA #
CAG85189OtherSTATE LICENSE #
CAP00092882OtherRAILROAD MEDICARE PROVIDER #