Provider Demographics
NPI:1306074497
Name:ALBIN, MICHAEL ASHLEY (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ASHLEY
Last Name:ALBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WEST BELLEVUE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105
Mailing Address - Country:US
Mailing Address - Phone:626-584-6116
Mailing Address - Fax:626-584-7886
Practice Address - Street 1:31 WEST BELLEVUE DRIVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105
Practice Address - Country:US
Practice Address - Phone:626-584-6116
Practice Address - Fax:626-584-7886
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA130605208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery