Healthcare Provider Details

I. General information

NPI: 1780128488
Provider Name (Legal Business Name): PIH HEALTH PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2016
Last Update Date: 07/09/2020
Certification Date: 07/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11480 BROOKSHIRE AVE STE 300
DOWNEY CA
90241-5023
US

IV. Provider business mailing address

PO BOX 1277
WHITTIER CA
90609-1277
US

V. Phone/Fax

Practice location:
  • Phone: 562-977-1690
  • Fax: 562-904-8836
Mailing address:
  • Phone: 562-789-5401
  • Fax: 562-789-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEITH S MIYAMOTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-789-5401