Provider Demographics
NPI:1770313686
Name:REGAN, MICHAEL W (NBC-HWC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:W
Last Name:REGAN
Suffix:
Gender:M
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 N ALTADENA DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2843
Mailing Address - Country:US
Mailing Address - Phone:626-665-6061
Mailing Address - Fax:
Practice Address - Street 1:2370 N ALTADENA DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-2843
Practice Address - Country:US
Practice Address - Phone:626-665-6061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach