Provider Demographics
NPI:1245044577
Name:MIHAYLOVA, MIHAELA GUEORGUIEVA
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:GUEORGUIEVA
Last Name:MIHAYLOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 VERA ST
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3746
Mailing Address - Country:US
Mailing Address - Phone:818-437-1492
Mailing Address - Fax:
Practice Address - Street 1:5805 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-2546
Practice Address - Country:US
Practice Address - Phone:818-900-6480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031462363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner