Healthcare Provider Details

I. General information

NPI: 1023837069
Provider Name (Legal Business Name): MIYA C YOSHIDA DO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 W LA VETA AVE STE 470
ORANGE CA
92868-4305
US

IV. Provider business mailing address

1010 W LA VETA AVE STE 470
ORANGE CA
92868-4305
US

V. Phone/Fax

Practice location:
  • Phone: 626-737-0986
  • Fax:
Mailing address:
  • Phone: 714-835-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MIYA C YOSHIDA
Title or Position: OWNER
Credential: DO
Phone: 714-706-9308