Basic Information
| Provider Information | |||||||||
| NPI: | 1770783482 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NORMAN | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 S ZEDIKER AVE | ||||||||
| Address2: | |||||||||
| City: | PARLIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936482666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596463561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 355 TERRACINA BLVD | ||||||||
| Address2: | |||||||||
| City: | REDLANDS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923734819 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093350400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2007 | ||||||||
| LastUpdateDate: | 12/07/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G45780 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.