Healthcare Provider Details

I. General information

NPI: 1114547098
Provider Name (Legal Business Name): FRANK JOSEPH MIGLIARESE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HEALTH CLINIC LEMOORE 937 FRANKLIN AVE
LEMOORE CA
93246-5000
US

IV. Provider business mailing address

NAVAL HEALTH CLINIC LEMOORE 937 FRANKLIN AVE
LEMOORE CA
93246-0001
US

V. Phone/Fax

Practice location:
  • Phone: 559-998-4800
  • Fax:
Mailing address:
  • Phone: 559-998-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101272996
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: