Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael John Michaelides Jr.

Individual provider Rehabilitation Practitioner · NPI 1003163270

Michael John Michaelides Jr. is a Rehabilitation Practitioner in Los Angeles, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2012
Specialties on file
2
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Practice location Address checks out

679 S New Hampshire Ave Ste 400
Los Angeles, CA 90005-1355
Phone: (213) 639-2500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 830 S Azusa Ave Trlr 36, Azusa, CA 91702-5582 — (626) 506-6443

Specialties & licences

Licensed Psychiatric Technician (primary) Taxonomy 167G00000X · Licence LPT42462 (CA)
Rehabilitation Practitioner Taxonomy 225400000X

Record details

NPI number1003163270
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 7, 2012
Last updated in NPPESFebruary 28, 2023
Certification dateFebruary 28, 2023

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