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:

Map and Directions

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 4 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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