Healthcare Provider Details

I. General information

NPI: 1164575544
Provider Name (Legal Business Name): PATRICK MILES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S SANTA CRUZ AVE STE 300
LOS GATOS CA
95030-6827
US

IV. Provider business mailing address

20 S SANTA CRUZ AVE STE 300
LOS GATOS CA
95030-6827
US

V. Phone/Fax

Practice location:
  • Phone: 408-890-6648
  • Fax:
Mailing address:
  • Phone: 408-890-6648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH3332
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberH3332
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD2010-0165
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberH3332
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD2010-0165
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: