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Michael Tiideberg
Family Nurse Practitioner in Canyon Lake, California
NPI 1538644521

Michael Tiideberg is a Family Nurse Practitioner based in Canyon Lake, CA and is specialized in Family. Michael Tiideberg practices in Canyon Lake, CA. The NPI Number for Michael Tiideberg is 1538644521 and holds a License No. 95009382 (California).

The current practice location address for Michael Tiideberg is 31630 Railroad Canyon Rd Ste 4, Canyon Lake, CA and can be reached out via phone at 951-837-6980.

Location: 31630 Railroad Canyon Rd Ste 4, Canyon Lake, CA, 92587-6904
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538644521
Provider Name
Michael Tiideberg
Credential
Provider Entity Type
Individual
Gender
Male
Address
31630 Railroad Canyon Rd Ste 4, Canyon Lake, CA, 92587-6904
Phone Number
951-837-6980
Fax Number
Provider Enumeration Date
09/26/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
31630 Railroad Canyon Rd Ste 4
City
Canyon Lake
State
California
Zip
92587-9478
Phone Number
951-837-6980
Fax Number
person
Provider Business Mailing Address Details
Address
31630 Railroad Canyon Rd Ste 4
City
Canyon Lake
State
California
Zip
92587-9478
Phone Number
951-837-6980
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
95009382 (California)
Definition
Definition to come...
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