Provider Demographics
NPI:1801686951
Name:HABER, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 FOOTHILL BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1671
Mailing Address - Country:US
Mailing Address - Phone:818-369-7700
Mailing Address - Fax:818-369-7702
Practice Address - Street 1:3800 FOOTHILL BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-1671
Practice Address - Country:US
Practice Address - Phone:818-369-7700
Practice Address - Fax:818-369-7702
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA308034225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist