Tiideberg, Michael
Tiideberg, Michael is an individual health care provider with primary practice located at 31630 Railroad Canyon Rd Ste 4 , Canyon Lake CA 92587-9478. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Tiideberg, Michael can be contacted via phone (951) 837-6980.Contact Information
Primary practice address
31630 Railroad Canyon Rd Ste 4
Canyon Lake CA 92587-9478
Phone: (951) 837-6980
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 95009382 | California |
Profile Details
NPI number | 1538644521 |
---|---|
LBN Legal business name | Tiideberg, Michael |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 26th, 2018 |
Last updated | Jul 25th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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