Provider Demographics
NPI:1023134749
Name:MICHAEL H GIROLAMI MD A MEDICAL CORPORATION
Entity type:Organization
Organization Name:MICHAEL H GIROLAMI MD A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:GIROLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-697-7643
Mailing Address - Street 1:1750 EL CAMINO REAL #11
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010
Mailing Address - Country:US
Mailing Address - Phone:650-697-7643
Mailing Address - Fax:650-697-7895
Practice Address - Street 1:1750 EL CAMINO REAL #11
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010
Practice Address - Country:US
Practice Address - Phone:650-697-7643
Practice Address - Fax:650-697-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23272174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA841899Medicare UPIN