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

SpecialtyCodeLicense #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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