Provider Demographics
NPI:1750475828
Name:MURRAY, MICHAEL TODD (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TODD
Last Name:MURRAY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2577 SAMARITAN DR STE 765
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4109
Mailing Address - Country:US
Mailing Address - Phone:408-358-6163
Mailing Address - Fax:408-358-2302
Practice Address - Street 1:2577 SAMARITAN DR STE 765
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4109
Practice Address - Country:US
Practice Address - Phone:408-358-6163
Practice Address - Fax:408-358-2302
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79157207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
008791571OtherMEDICARE PTAN
I07667Medicare UPIN