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: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR CARDIOLOGY CLINIC
SAN DIEGO CA
92134-0001
US

IV. Provider business mailing address

34800 BOB WILSON DRIVE CARDIOLOGY CLINIC
SAN DIEGO CA
92134-0001
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7400
  • Fax: 619-532-9863
Mailing address:
  • Phone: 619-532-7400
  • Fax: 619-532-9863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101272996
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: