Search › California › 163W00000X
Tara Micich
NPI 1174480719 · on the registry since 2026 · sole proprietor
Practice
- Address
- 2410 S Redondo Blvd
Los Angeles, CA 90016 - Phone
- (862) 763-2079
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-01-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California