Basic Information
| Provider Information | |||||||||
| NPI: | 1821219965 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WITHEE | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2245 LILLIE AVE | ||||||||
| Address2: | #230 | ||||||||
| City: | SUMMERLAND | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930677001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8058457792 | ||||||||
| FaxNumber: | 8885018991 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 W PUEBLO ST | ||||||||
| Address2: | |||||||||
| City: | SANTA BARBARA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 931054353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8056827111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 11/05/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 40963 | AZ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | C129695 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.