Michael Tiideberg
Michael Tiideberg is a Nurse Practitioner in Canyon Lake, California. Qualified in 2016, 10 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.
- Years since qualifying
- 10
- Licensed in
- CA
- In the registry since
- 2018
Practice location Address checks out
31630 Railroad Canyon Rd Ste 4Canyon Lake, CA 92587-9478
Phone: (951) 837-6980
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Nurse Practitioner (primary) | Taxonomy 363LF0000X · Licence 95009382 (CA) |
|---|
Record details
| NPI number | 1538644521 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 26, 2018 |
| Last updated in NPPES | July 25, 2022 |
| Mailing address | 22724 Lighthouse Dr, Canyon Lake, CA 92587-6904 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2016 (10 years in practice) |
| Group practice | Southern California Permanente Medical Group — 11242 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Canyon Lake
-
Kylie Moberg
22725 Canyon Lake Dr N, Canyon Lake, CA 92587-8014 · (951) 723-0984
-
Cyril Morgan
28921 Yosemite Pl, Canyon Lake, CA 92587-7810 · (949) 892-0131
-
MS. Valerie Lynn Spalding, NP
29998 Windward Dr, Canyon Lake, CA 92587-7481 · (951) 893-8212