Healthcare Provider Details

I. General information

NPI: 1962756890
Provider Name (Legal Business Name): MYLES SORIANO PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74590 HIGHWAY 111
PALM DESERT CA
92260-3804
US

IV. Provider business mailing address

PO BOX 7583
RIVERSIDE CA
92513-7583
US

V. Phone/Fax

Practice location:
  • Phone: 760-346-2573
  • Fax:
Mailing address:
  • Phone: 951-505-7865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: