MICHAEL A MEDEIROS (NPI# 1417120866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417120866 |
| Entity Type | Individual |
| Full Name | MICHAEL A MEDEIROS |
| Credential | M.D. |
| Practice Address |
2256 Dockery Ave Ste B Selma CA 93662-3874 |
| Mailing Address |
4032 W Swanson Ave Caruthers CA 93609-9552 |
| Practice Telephone | 5598566170 |
| Practice Fax Number | 5598566172 |
| Mailing Telephone | 5598566170 |
| Mailing Fax Number | 5598566172 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2019-12-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A117400 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
64725 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | LICENSE NUMBER | 18511 | 01 |
| CA | LICENSE NUMBER | A117400 | 01 |
| CA | CAQH NUMBER | 12583839 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1012 E 2nd St, Duluth, MN 558052200 | 2182497655 | 2182496989 |
| 1155 Mill St, Reno, NV 895021576 | 7759827878 | 7759824196 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184150088 | Michael F Medeiros | Occupational Therapist | 75 Midwood Dr, Swansea, MA 02777-3512 | 2017-05-11 |
| 1225177058 | Michael David Medeiros | Chiropractor | 473 South St W, Raynham, MA 02767-5306 | 2007-02-06 |
| 1184687956 | Michael Medeiros | Specialist/Technologist | 75 Adams Dr, Portsmouth, RI 02871-5428 | 2006-04-11 |
| 1649290651 | Michael Medeiros | Dentist | 30 E 40th St, Suite 207, New York, NY 10016-1201 | 2006-07-20 |
| Street Address |
2256 DOCKERY AVE STE B |
| City | SELMA |
| State | CA |
| Zip Code | 93662-3874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215416839 | United Health Centers of The San Joaquin Valley | Clinic/Center | 2705 S Highland Ave, Selma, CA 93662 | 2018-08-14 |
| 1265930598 | Sharon King | Home Health Aide | 6296 E. Mt. View Ave, Selma, CA 93662 | 2018-02-01 |
| 1174972095 | Ranjit Kaur | Nurse's Aide | 1805 Aspen Street, Selma, CA 93662 | 2016-06-10 |
| 1548629223 | Navjot Sihota | Dentist | 14409 South Dewolf Ave, Selma, CA 93662 | 2016-02-23 |
| 1437482676 | K.w. Kim, A Professional Corp | Internal Medicine | 1205 Evergreen Street, Selma, CA 93662 | 2009-09-04 |
| 1467638536 | Lungren Chiropractic Center Inc | Chiropractor | 1850 Floral Ave, Selma, CA 93662 | 2008-01-18 |
| 1164634333 | Gerald Lynn Thomas | Pharmacist | 2640 Floral Ave, Selma, CA 93662 | 2007-05-03 |
| 1306989652 | Donald Henry Jacobsen | Dentist | 1221 Rose Ave, Selma, CA 93662 | 2007-02-15 |
| 1306988746 | California Occupational Medicine Practice Inc | Preventive Medicine | 1142 Rose Avenue, Selma, CA 93662 | 2007-02-13 |
| 1962548925 | Courtney Joseph Moore | Physical Therapist | 2251 Country Club Lane, Selma, CA 93662 | 2007-01-29 |
| Find all providers in zip 93662 | ||||
| Taxonomy Code | 2084N0600X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Clinical Neurophysiology |
| Clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
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| 1578116877 | La Neuro Medical Group | Psychiatry & Neurology | 11843 Dorothy St Apt 2, Los Angeles, CA 90049-4456 | 2019-07-17 |
| 1518527613 | Neuroguard Pro | Psychiatry & Neurology | 2932 N Cottonwood St Unit 16, Orange, CA 92865-1235 | 2019-06-19 |
| 1750857801 | Tms Depression Center of San Diego | Psychiatry & Neurology | 613 W Valley Pkwy Ste 102, Escondido, CA 92025-2550 | 2018-10-16 |
| 1225530637 | Iom Neuro Pro Reader | Psychiatry & Neurology | 9300 Santa Anita Ave, Suite 101, Rancho Cucamonga, CA 91730 | 2018-03-01 |
| 1437579851 | Sami Bajwa | Psychiatry & Neurology | 7240 N Van Ness Blvd, Fresno, CA 93711-0470 | 2014-04-24 |
| 1780935130 | Dawn Eliashiv Md Inc. A Professional Medical Corporation | Psychiatry & Neurology | 8635 W 3rd St Ste 1080w, Los Angeles, CA 90048-6183 | 2012-09-25 |
| 1073821922 | Yuvraj Singh Grewal | Psychiatry & Neurology | 23861 Mcbean Pkwy Ste A4, Santa Clarita, CA 91355-2003 | 2010-09-14 |
| 1952629263 | Roger Bertoldi Md Professional Corporation | Psychiatry & Neurology | 8610 S. Sepulveda Blvd., Los Angeles, CA 90045 | 2010-05-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.