Provider Demographics
NPI:1194316695
Name:GEORGE, MICHAEL (CRT, RRT, BSRT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:GEORGE
Suffix:
Gender:M
Credentials:CRT, RRT, BSRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9321 MANOR FOREST LN
Mailing Address - Street 2:
Mailing Address - City:SHAFTER
Mailing Address - State:CA
Mailing Address - Zip Code:93263-9443
Mailing Address - Country:US
Mailing Address - Phone:661-444-1135
Mailing Address - Fax:
Practice Address - Street 1:3001 SILLECT AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6337
Practice Address - Country:US
Practice Address - Phone:661-316-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YP1600X
CA309512279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral