Provider Demographics
NPI:1538854575
Name:MICHEL, CLAIRE MARIE (OD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:MICHEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 N CENTRAL AVE UNIT 1411
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4255
Mailing Address - Country:US
Mailing Address - Phone:586-914-0077
Mailing Address - Fax:
Practice Address - Street 1:795 E 2ND ST STE 2
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:586-914-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist