Basic Information
| Provider Information | |||||||||
| NPI: | 1508938168 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL B. STRAUSS, MD, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5150 E. PACIFIC COAST HWY | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908043328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5622995239 | ||||||||
| FaxNumber: | 5622995294 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 E. 28TH STREET | ||||||||
| Address2: | SUITE 416 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908062787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624275823 | ||||||||
| FaxNumber: | 5624272255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2006 | ||||||||
| LastUpdateDate: | 01/03/2012 | ||||||||
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| AuthorizedOfficialLastName: | STRAUSS | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | B. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5624275823 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0004X | G13753 | CA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery | 207X00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 00G137531 | 05 | CA | MEDICAID |