Provider Demographics
NPI:1700965738
Name:POLLATSEK, MICHAEL E (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:POLLATSEK
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 1:1440 ACTON CRES
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94702-1919
Mailing Address - Country:US
Mailing Address - Phone:510-549-1492
Mailing Address - Fax:510-705-1987
Practice Address - Street 1:1440 ACTON CRES
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94702-1919
Practice Address - Country:US
Practice Address - Phone:510-549-1492
Practice Address - Fax:510-705-1987
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG117062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC98893Medicare UPIN